To evaluate long-term results of an anterior lumbar fusion with posterior instrumentation using a bicortical iliac allograft.

Fifty-one patients underwent anterior lumbar fusion with posterior instrumentation using an iliac allograft. This study included 28 patients and 37 levels, and was followed for at least 5 years. Clinical and radiological results were evaluated.

Bony fusion was obtained in 92% of the levels and excellent or good clinical results were achieved in 82% of the patients. Mean intervertebral disc space of 10.7 mm preoperatively was increased to 14.6 mm postoperatively and became 12 mm at final follow-up. Ascrew breakage was noted in one patient.

Our data suggest that bicortical iliac allograft is a satisfactory graft material and produces acceptable clinical and radiological results in anterior lumbar fusion with posterior instrumentation. However, with respect to fusion quality the allograft should be a substitute for autograft in selected case.