The clinical use of the enriched bone marrow obtained by selective cell retention technology in treating adolescent idiopathic scoliosis

Purpose: This retrospective study aimed to evaluate the curative effect of allografts in combination with bone marrow enrichment realised by selective cell retention (SCR) technology in treating adolescent idiopathic scoliosis (AIS). Methods: From July 2014 to September 2016, 18 consecutive patients with AIS were treated by posterior fusion and pedicle screw instrumentation. Bone marrow aspirates were obtained and enriched by SCR technology to fabricate bone grafts in combination with allogeneic bones, which were implanted for spinal fusion. Postoperatively, the patients were observed for a minimum of 18 months, with a mean follow-up period of 48 months. The results were assessed both clinically and radiographically. All adverse events and complications were recorded. Results: A total of 9 male and 9 female patients were included, with an average age of 15.6 years (range, 12–20). The average preoperative Cobb angle was 56° (range, 47°–85°). The average number of levels fused was 11 (range, 9–13). SCR could be accomplished intraoperatively, only consuming approximately 20 ​min. The enriching multiples of measured cellular elements were approximately 2.3–4.2. At final follow-up, the average Cobb angle correction was 83% (range, 61–96%). There was no obvious loss in correction with an average loss of 1.1° (2%). The visual analogue scale score and the Oswestry Disability Index score at final follow-up were significantly ameliorated than those preoperatively. The Scoliosis Research Society 30 questionnaire revealed remarkable improvement in the domains “pain”, “self-image/appearance”, and “satisfaction with management”. There was neither pseudarthrosis nor severe complication. Conclusion: The use of SCR technology could be considered as an effective method for promoting spinal fusion in treating AIS. We proposed a safe, simple, and rapid approach to obtain effective bone grafts for spinal fusion. The translational potential of this article: Enriched bone marrow obtained by selective cell retention technology has the potential to promote spinal fusion for the treatment of adolescent idiopathic scoliosis.