Spinal fusion requires the use of bone graft. That bone may be
taken
from the patient's own body (called
autograft), from a cadaver (called allograft),
or from an animal (called
xenograft). Other than bone grafts, there are
some
materials which promotes spinal fusion. Main examples are bone
morphogenetic proteins (BMPs) and demineralized bone matrix (DBM).
There are three ways the biology of bone
works: osteoinduction, osteoconduction and osseointegration.
Osteoinduction refers to primitive, undifferentiated and
pluripotent
cells are somehow stimulated to develop into the bone-forming cell
lineage. That cause new bone to form where bone doesn't already exist.
Autograft bone and BMPs fall into this
category. Osteoconduction refers to the way bone graft
material builds a
scaffold, the framework for bone to fill inside. An
osteoconductive material permits bone growth on its surface or down
into pores, channels or pipes. Allografts (cadaver bone), coral, and
ceramics are examples of materials which their osteoconductive
properties are very good. Osteointegration is the structural and
functional connection between
growing bone and the surface of a spinal artificial implant.
Choice of the material for spinal fusion depends on many factors. Use
of autograft remains the gold standard for
spinal fusions.
Autograft has all properties of an ideal fusion material, namely; osteoinduction, osteoconduction and osseointegration. However, use of allografts and BMPs have certain advantages. There is less blood loss, shorter surgery time, and no pain or other problems at the graft site.
Below, you will find main categories of materials for spinal fusion.
Any comment about this page?
Your feedback is appreciated. Please click
here.
To join Scientific Spine mailing list, click here.