{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:35:41Z","timestamp":1771925741310,"version":"3.50.1"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Bone allografts used for interbody spinal fusion are often preserved through either freeze drying or lowtemperature freezing, each having disadvantages related to graft preparation time and material properties. In response, a glycerol preservation treatment has been developed to maintain the biomechanical properties of allografts at ambient temperatures, requiring no thawing or rehydration and minimal rinsing prior to implantation. The authors conducted a prospective randomized study to compare the clinical results of glycerol-preserved Cloward dowels and those of freezedried Cloward dowels in anterior cervical discectomy and fusion. The primary outcome measures were evidence of fusion and graft subsidence, and the secondary outcome measures included adverse events, pain, and neck disability scores.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Of 106 patients, 53 (113 levels of surgery) were randomly assigned to the glycerol-preserved graft group and 53 (114 levels of surgery) to the freeze-dried graft group. Subsidence was assessed at 3 and 6 months after implantation. Evidence of fusion was evaluated radiographically at 6 months postimplantation. Subsidence was quantitatively assessed based on physical measurements obtained from radiographs by using calibrated comparators, whereas fusion was also evaluated visually. Surgeons were blinded to treatment type during visual and physical assessments of the patients and the radiographs.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>No one in either group had evidence of complete nonunion according to radiographic evaluation at the 6-month follow-up. Average subsidence for all graft-treated levels was 2.11 mm for the glycerol-preserved group and 2.73 mm for the freeze-dried group at the 3-month follow-up and 2.13 and 2.83 mm at the 6-month follow-up, respectively. The 2 treatment groups were statistically equivalent (p = 0.2127 and 0.1705 for the 3- and 6-month follow-up, respectively). No differences were noted between the graft types in terms of adverse event incidence or severity.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Glycerol-preserved bone allografts exhibit fusion results and subsidence values similar to those of their freeze-dried counterparts, potentially more favorable biomechanical properties, and significantly shorter preparation times.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.9.spine131005","type":"journal-article","created":{"date-parts":[[2014,10,31]],"date-time":"2014-10-31T14:02:53Z","timestamp":1414764173000},"page":"1-10","source":"Crossref","is-referenced-by-count":24,"title":["Evaluation of glycerol-preserved bone allografts in cervical spine fusion: a prospective, randomized controlled trial"],"prefix":"10.3171","volume":"22","author":[{"given":"R. Scott","family":"Graham","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University Health Systems, Medical College of Virginia, Richmond; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian J.","family":"Samsell","sequence":"additional","affiliation":[{"name":"Institute of Regenerative Medicine, LifeNet Health, Virginia Beach, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Proffer","sequence":"additional","affiliation":[{"name":"Institute of Regenerative Medicine, LifeNet Health, Virginia Beach, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Moore","sequence":"additional","affiliation":[{"name":"Institute of Regenerative Medicine, LifeNet Health, Virginia Beach, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael A.","family":"Vega","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University Health Systems, Medical College of Virginia, Richmond; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel M.","family":"Stary","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University Health Systems, Medical College of Virginia, Richmond; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Mathern","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University Health Systems, Medical College of Virginia, Richmond; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine131005","series-title":"Cell Tissue Bank","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s10561-008-9069-0","article-title":"Effect of low dose and moderate dose gamma irradiation on the mechanical properties of bone and soft tissue allografts","volume":"9","author":"Balsly","year":"2008"},{"key":"b2-spine131005","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/BF01407775","article-title":"Complications of anterior cervical discectomy without fusion in 450 consecutive patients","volume":"99","author":"Bertalanffy","year":"1989"},{"key":"b3-spine131005","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"206","DOI":"10.3171\/jns.1996.85.2.0206","article-title":"Anterior cervical interbody fusion using autogeneic and allogeneic graft substrate: a prospective comparative analysis","volume":"85","author":"Bishop","year":"1996"},{"key":"b4-spine131005","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1097\/00007632-200008150-00007","article-title":"Three- and four-level anterior cervical discectomy and fusion with plate fixation: a prospective study","volume":"25","author":"Bolesta","year":"2000"},{"key":"b5-spine131005","series-title":"Dent Mater","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1016\/j.dental.2009.03.007","article-title":"Freeze-dried acellular dermal matrix graft: effects of rehydration on physical, chemical, and mechanical properties","volume":"25","author":"Bottino","year":"2009"},{"issue":"119","key":"b6-spine131005","series-title":"Clin Orthop Relat Res","first-page":"231","article-title":"A roentgenographic evaluation of frozen allografts versus autografts in anterior cervical spine fusions","author":"Brown","year":"1976"},{"key":"b7-spine131005","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.spinee.2006.12.006","article-title":"Prospective nonrandomized comparison of an allograft with bone morphogenic protein versus an iliaccrest autograft in anterior cervical discectomy and fusion","volume":"8","author":"Buttermann","year":"2008"},{"key":"b8-spine131005","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"602","DOI":"10.3171\/jns.1958.15.6.0602","article-title":"The anterior approach for removal of ruptured cervical disks","volume":"15","author":"Cloward","year":"1958"},{"key":"b9-spine131005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"348","DOI":"10.3171\/2011.5.SPINE10769","article-title":"Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up. Clinical article","volume":"15","author":"Coric","year":"2011"},{"issue":"Suppl 1","key":"b10-spine131005","series-title":"Burns","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/0305-4179(94)90080-9","article-title":"Euro Skin Bank: large scale skin-banking in Europe based on glycerol-preservation of donor skin","volume":"20","author":"de Backere","year":"1994"},{"key":"b11-spine131005","series-title":"J Arthroplasty","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1054\/arth.2001.20250","article-title":"Impaction bone grafting using freeze-dried allograft in revision hip arthroplasty","volume":"16","author":"de Roeck","year":"2001"},{"key":"b12-spine131005","series-title":"J Bone Joint Surg Am","first-page":"251","article-title":"Accurate identification of adverse outcomes after cervical spine surgery","volume":"86-A","author":"Edwards","year":"2004"},{"key":"b13-spine131005","series-title":"Oper Tech Orthop","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/S1048-6666(03)00023-5","article-title":"Anterior cervical discectomy and fusion","volume":"13","author":"Goldberg","year":"2003"},{"key":"b14-spine131005","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3171\/spi.2005.3.3.0210","article-title":"Radiculopathy of C-5 after anterior decompression for cervical myelopathy","volume":"3","author":"Ikenaga","year":"2005"},{"key":"b15-spine131005","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1097\/01.bsd.0000177211.44960.71","article-title":"Influence of anterior cervical plate design on dysphagia: a 2-year prospective longitudinal follow-up study","volume":"18","author":"Lee","year":"2005"},{"key":"b16-spine131005","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.spinee.2006.02.024","article-title":"Risk factors for dysphagia after anterior cervical spine surgery: a two-year prospective cohort study","volume":"7","author":"Lee","year":"2007"},{"key":"b17-spine131005","series-title":"Burns","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/0305-4179(95)00006-2","article-title":"Effect of glycerol on intracellular virus survival: implications for the clinical use of glycerol-preserved cadaver skin","volume":"21","author":"Marshall","year":"1995"},{"key":"b18-spine131005","series-title":"Cell Tissue Bank","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1007\/s10561-011-9266-0","article-title":"Inactivation of enveloped and non-enveloped viruses on seeded human tissues by gamma irradiation","volume":"13","author":"Moore","year":"2012"},{"key":"b19-spine131005","article-title":"The effects of an alternate preservation method on the biomechanical strength of allograft tissue","author":"Moore"},{"key":"b20-spine131005","series-title":"Spine J","first-page":"275","article-title":"Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease","volume":"9","author":"Murrey","year":"2009"},{"key":"b21-spine131005","series-title":"SAS J","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/S1935-9810(08)70022-7","article-title":"Two-year results of a randomized controlled clinical trial comparing ProDisc-c and anterior cervical discectomy and fusion","volume":"2","author":"Murrey","year":"2008"},{"key":"b22-spine131005","series-title":"Clin Biomech (Bristol, Avon)","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.clinbiomech.2004.01.010","article-title":"Biomechanical strength of deep-frozen versus lyophilized large cortical allografts","volume":"19","author":"Nather","year":"2004"},{"key":"b23-spine131005","series-title":"Burns","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.burns.2009.04.020","article-title":"Processing efficacy in relation to microbial contamination of skin allografts from 723 donors","volume":"36","author":"Pianigiani","year":"2010"},{"key":"b24-spine131005","series-title":"Burns","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.burns.2007.02.009","article-title":"Short- and long-term bacterial inhibiting effect of high concentrations of glycerol used in the preservation of skin allografts","volume":"34","author":"Saegeman","year":"2008"},{"key":"b25-spine131005","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/j.spinee.2013.02.038","article-title":"Surgically treated cervical myelopathy: a functional outcome comparison study between multilevel anterior cervical decompression fusion with instrumentation and posterior laminoplasty","volume":"13","author":"Seng","year":"2013"},{"key":"b26-spine131005","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1097\/01.BRS.0000129100.59913.EA","article-title":"Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures","volume":"29","author":"Smith-Hammond","year":"2004"},{"key":"b27-spine131005","article-title":"The effects of a new preservation method on the biomechanics and shelf life of allograft bone","author":"Sohoni"},{"key":"b28-spine131005","series-title":"Clin Neurosurg","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1093\/neurosurgery\/23.CN_suppl_1.424","article-title":"Complications of surgery of the anterior cervical spine","volume":"23","author":"Tew","year":"1976"},{"key":"b29-spine131005","series-title":"Curr Orthop","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1054\/cuor.2002.0243","article-title":"Cervical spondylosis. Part II: Surgical management","volume":"16","author":"Torrens","year":"2002"},{"issue":"2 Suppl","key":"b30-spine131005","series-title":"J Neurosurg","first-page":"186","article-title":"Graft subsidence after instrument-assisted anterior cervical fusion","volume":"97","author":"Tye","year":"2002"},{"key":"b31-spine131005","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1007\/s00586-007-0351-9","article-title":"Complications of anterior cervical discectomy and fusion using recombinant human bone morphogenetic protein-2","volume":"16","author":"Vaidya","year":"2007"},{"issue":"Suppl 1","key":"b32-spine131005","series-title":"Burns","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1016\/0305-4179(94)90096-5","article-title":"Virucidal effect of glycerol as used in donor skin preservation","volume":"20","author":"van Baare","year":"1994"},{"key":"b33-spine131005","series-title":"Transplantation","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1097\/00007890-199804150-00017","article-title":"Microbiological evaluation of glycerolized cadaveric donor skin","volume":"65","author":"van Baare","year":"1998"},{"key":"b34-spine131005","series-title":"J Spinal Disord","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/00002517-200102000-00003","article-title":"Cervical spondylosis: the role of anterior instrumentation after decompression and fusion","volume":"14","author":"Zaveri","year":"2001"},{"key":"b35-spine131005","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1097\/00007632-199107000-00006","article-title":"The use of freeze-dried allograft bone for anterior cervical fusions","volume":"16","author":"Zdeblick","year":"1991"},{"key":"b36-spine131005","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s00586-010-1583-7","article-title":"Artificial total disc replacement versus fusion for the cervical spine: a systematic review","volume":"20","author":"Zechmeister","year":"2011"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/1\/article-p1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/1\/article-p1.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/22\/1\/article-p1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:22:29Z","timestamp":1681593749000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/22\/1\/article-p1.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":36,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2014.9.spine131005","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2015,1]]}}}