Biomechanical comparison of bone graft used in anterior spinal reconstruction : freeze-dried demineralized femoral segments versus fresh fibular segments and tricortical iliac blocks in autopsy specimens

This study compares the compression strength of frozen corticocancellous iliac blocks and short fibular segments with freeze-dried, partially ("surface") demineralized microperforated (FDPDM) short femoral segments. Three blocks from each iliac crest and segments from the fibular and femoral diaphyses were retrieved. The femoral segments were microperforated, demineralized for 24 hours, and freeze-dried. All were then loaded to failure in a stress testing machine. The FDPDM showed a significantly higher failure load and stiffness than the fibular segments and the iliac crest segments. The femoral and fibular segments were similar in strength but significantly higher than iliac crest grafts. Compared with commonly used frozen grafts, freeze-dried partially demineralized femoral segments may be used safely as axial load-bearing struts in anterior spine reconstruction.