Outcomes of posterior spinal fusion for adolescent idiopathic scoliosis are not affected by the use of autologous iliac crest graft

Spinal fusion in adolescent idiopathic scoliosis requires the use of bone grafting material, and options include autologous bone graft, which may be obtained from the iliac crest, or allograft bone material.  Many surgeons have asked whether harvesting autologous bone graft (in some cases, through a separate incision) will affect the clinical outcomes either in satisfaction with appearance or through donor site morbidity.  Using a prospective multi-center database, Crawford et al. compared the results of the Scoliosis Research Society (SRS)-22 questionnaire at 2 years after surgery in 342 patients who underwent iliac crest bone graft harvest to 563 patients who did not.  Their findings were published in Spine Deformity, “Outcomes Following Posterior Fusion for Adolescent Idiopathic Scoliosis With and Without Autogenous Iliac Crest Bone Graft Harvesting“.  The authors found that although operative blood loss estimates and operative times were greater when performing iliac crest bone graft during spinal fusion surgery, there was no difference in clinical outcomes measures by two years after surgery.  These findings suggest that autologous iliac crest bone graft remains an acceptable option for spinal fusion in adolescent idiopathic scoliosis.