Comparison of Allograft and Autograft in Lumbar Fusion for Lumbar Degenerative Diseases: A Systematic Review

ABSTRACT

Purpose/Aim of the study: The purpose of this analysis was to compare the clinical outcomes of vertebral fusion with allograft versus autograft bone. Materials and Methods: Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until July 27, 2015 using the keywords: lumbar vertebrae, surgery, spondylolisthesis, bone transplantation, allograft, autograft. Inclusion criteria were randomized controlled trials (RCTs), two-arm prospective studies, retrospective studies, and cohort studies comparing the results of autograft and allograft in patients receiving lumbar spinal fusion. The outcomes were changes of Oswestry Disability Index (ODI) and visual analogue scale (VAS) pain scores from baseline at 1, 2, and 3 years after surgery and fusion rates. Results: Of 154 studies identified in the database searches, five were included in the quantitative analysis (one RCT, one prospective, and three retrospective studies). The mean patient age ranged from approximately 40 to 65 years, and approximately half of the patients were males. The total number of patients who received allografts was 333 and the total that received autografts was 175. The analysis revealed the change of ODI and VAS pain score at 1, 2 and 3 years was similar between the allograft and autograft groups (all, p > .05), as were the fusion rates (p > .05). Conclusions: Both allograft and autograft provide acceptable outcomes for spinal fusion.

Keywords::

• allograft
• autograft
• degenerative disc disease
• lumbar fusion
• meta-analysis
• systematic review