Although using a patient's own bone has traditionally been the gold standard for spinal fusion, science and technology have increased the number of synthetic graft options. Using these graft alternatives can essentially eliminate the potential problems associated with harvesting bone from a donor site, such as post-operative pain, and rates of fusion are quite acceptable using these alternative methods.
See Autograft: The Patient's Own Bone
Considerations with Synthetic Bone Graft Options
- There are specific, genetically engineered bone growth proteins (BMP: Bone Morphogenetic Proteins) which stimulate fusion.
- There are also preparations of bone growth factors harvested from donated bone (demineralized bone matrices/DBMs).
- Another option is to harvest the patient’s bone marrow and apply it to a synthetic scaffold as a way to deliver the cells that make bone to the fusion site.
Every method of bone grafting has its own advantages and disadvantages (pain, scarring, infection, cost, etc), but there are many viable options and patients are well-served to be educated about their choices regarding this aspect of a spinal fusion, and proactively work together with their surgeon to select the option that is right for them.
References
- 1.Ebraheim NA, Elgafy H, Xu R. Bone-Graft Harvesting From Iliac and Fibular Donor Sites: Techniques and Complications. 2001 JAAOS 9(3):210-18
