A Roentgenographic Evaluation of Frozen Allografts versus Autografts in Anterior Cervical Spine Fusions

Serial roengenograms of 53 patients who had 76 cervical interspaces grafted with frozen, bone marrrow-free cadaver bone were compared to those obtained from 45 patients who received 63 iliac crest autografts for anterior cervical spine fusion. The roentgenograms were evaluated on the basis of achieving union, delayed union, non-union, and the presence of graft collapse and extrusion. No significant difference was noted in the union rate, with allografts (94%) or with autografts (97%). In 21 patients a higher rate of graft collapse was noted with allografts as compared to autografts in multilevel fusions. In these patients, allograft rejection or the biomechanical properties of the allograft may have contributed to a difference in the rate of graft collapse with cadaver bone. No difference in collapse rate was noted between allografts and autografts in 32 patients with single level fusions. Insertion of frozen bone allografts into intervertebral spaces of the cervical spine has not produced adverse reactions.