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BONE GRAFTS IN SPINAL FUSION
Bone grafts refer to the use of bone to link or weld bones together in spinal fusion surgery. Typically, many spinal conditions cause instability and/or pain (eg, degenerative disc disease, scoliosis, trauma) and require treatment with a spinal fusion.
The Surgeons at the Southwest Scoliosis and Spine Institute have completed over 16,000 surgical procedures for 100,000 patients
Bone Graft Types
Spinal fusion defines a surgical procedure commonly used to treat various spinal conditions, such as degenerative disc disease, spinal fractures, or spinal instability. Primarily, the success of spinal fusion heavily relies on the integration and fusion of bone grafts, which facilitate the formation of a solid bone mass. In this article, we will explore the different types of bone grafts used in spinal fusion procedures, their sources, and their benefits.
A basic part of any spinal fusion involves a bone graft. At the present time, doctors use bone grafting for many types of orthopedic procedures that require bones to heal. Chiefly, bone grafting provides two solutions during certain procedures:
- to stimulate the bone to heal
- to provide support to the skeleton by filling gaps between two bones
Stimulate Healing
Doctors use bone grafts to stimulate the healing process of bones. Additionally, crushed bone tissue placed around a fracture or a fusion site contains chemicals in it that stimulate the nearby bones to heal. If the bone source comes from the patient’s own body, osteocytes (living bone cells) may survive the transfer to the new location and continue to do their work of making new bone. Even bone taken from someone else will stimulate the bone to heal. However, bone taken from the same person may fair better because the chances seem higher that it will possess remaining live bone cells after the transfer.
Questions and Answers
What constitutes a bone graft, and why do doctors use it for spinal fusion surgery?
A bone graft procedure occurs when a doctor transplants bone tissue to promote bone healing, fusion, or repair. In spinal fusion surgery, bone grafts encourage the formation of a solid bone mass between two or more vertebrae. This fusion helps stabilize the spine, alleviate pain, and restore proper alignment.
What are the different types of bone grafts used in spinal fusion surgery?
For spinal fusion surgery, doctors use bone grafts called autografts, allografts, synthetic bone grafts, and bone morphogenetic proteins (BMPs). Autografts involve using the patient’s own bone tissue, typically harvested from the hip. Allografts use bone tissue from a cadaveric donor. Synthetic bone grafts constitute man-made materials that mimic natural bone, while BMPs refer to genetically engineered proteins that promote bone growth.
How is the choice of bone graft determined for spinal fusion surgery?
The choice of bone graft depends on various factors, including the patient’s condition, the extent of fusion required, and the surgeon’s preference and expertise. Doctors consider autografts as the gold standard due to their high success rate and ability to provide live bone cells and growth factors. Allografts are commonly used as a supplement or alternative to autografts. Synthetic bone grafts offer convenience and eliminate the need for additional surgical sites. Surgeons will use BMPs in specific cases involving special circumstances.
Bone Grafts Provide Support
A bone graft refers to a supporting structure. Rather than crush the bone into fine pieces, larger pieces of bone fill gaps or voids between two bones. For example, if the surgeon removes a vertebra or disc, he or she may place a chunk of bone graft into the empty space. To clarify, the hard or rigid bone will hold the bones apart while the body grows to the ends of the graft. Over time, the entire piece of bone that was grafted will become “remodeled” and replaced by the body with new bone. Also, the time it takes to fuse depends on the size of the piece of bone that was used. Despite taking a long time to completely heal — a slow process works and may take several years.
Bone Graft Types
Medical companies provide several different kinds of bone graphs. The following identify them.
Autografts:
Surgeons consider Autografts as the gold standard for bone grafting in spinal fusion surgery. These grafts use bone from the patient’s own body, typically from the iliac crest (hip bone). Therefore, autografts provide live bone cells, growth factors, and proteins necessary for bone regeneration. Furthermore, this type of graft maintains a high success rate and promotes efficient fusion. However, the main drawback is the need for an additional surgical site, which can cause discomfort and potential complications.
Allografts:
Allografts involve using bone tissue obtained from a cadaveric donor. Meanwhile, this type of bone graft eliminates the need for an additional surgical site, reducing patient discomfort. Allografts undergo extensive processing and sterilization to minimize the risk of disease transmission and rejection. Lastly, they provide a structural framework for bone regeneration and help promote fusion. However, they lack the live cells and growth factors found in autografts, which may slightly impact the fusion process. Occasionally, surgeons use allografts to supplement autografts or in situations where doctors do not use an autograft.
Synthetic Bone Grafts:
Synthetic bone grafts mimic the properties of natural bone. Generally, these grafts contain materials such as ceramics, calcium phosphate, or calcium sulfate. Nevertheless, synthetic grafts provide a framework for new bone growth and gradually resorb over time as the patient’s own bone takes its place. Overall, they eliminate the need for harvesting bone from the patient or relying on cadaveric donations. Lastly, synthetic grafts have the advantage of consistent quality, reduced risk of disease transmission, and availability. However, they may take longer for fusion to take place as compared to autografts or allografts, and doctors continue to study their long-term effectiveness.
Bone Morphogenetic Proteins (BMPs):
Bone morphogenetic proteins (BMPs) are a group of naturally occurring proteins that play a critical role in bone formation and healing. Surgeons can use these as an alternative or in combination with traditional bone grafts. The production of BMPs get produced through genetic engineering and available in synthetic forms. For this purpose, they seem highly potent in promoting bone growth and fusion. However, Surgeons reserve BMPs for specific cases because of potential complications, such as inflammation and excessive bone growth.
New Technology for a Bone Graft
Medical research continues to design bone graft substitutes, chemicals, and devices that stimulate the bones to fuse. Furthermore, Electrical current stimulates bone to grow and so surgeons use electrical stimulation devices to speed up a fusion. In Addition, some artificial bone graft materials have been developed. For instance, sea coral, harvested from the oceans, sometimes provides a successful structural bone replacement. Other developments include
- Demineralized bone matrix (DBM): Developed from cadaver bones in a bone bank. Calcium gets removed from the bone turning the material into a putty, sheet, or gel. Surgeons can then add the material to a graft site to improve the fusion.
- Autologous growth factor (AGF): A solution used to stimulate bone growth. Developed in a laboratory from blood platelets (the clotting part of the blood). The mixture is usually used in combination with some form of structural support, such as autograft or fusion cages.
- Bone morphogenic protein (BMP): A chemical added to bone graft to enhance bone growth when added to a fusion site.
Conclusion:
Bone grafts play a vital role in facilitating successful spinal fusion procedures. Based on the patient’s condition, surgeons have autografts, allografts, synthetic bone grafts, and BMPs as graft options. Each type has its advantages and considerations. The choice depends on various factors, including the patient’s condition, the extent of fusion required, and the surgeon’s preference and expertise. Patients should consult with an experienced orthopedic surgeon to determine the most suitable bone graft option for each individual case, ensuring optimal fusion and successful long-term outcomes.
The Reasons Why Patients Choose the Southwest Scoliosis and Spine Institute.
- Spine expertise: The team of specialists at Southwest Scoliosis and Spine Institute is comprised of spine experts. They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
- Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions. In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
- Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery. We ensure that patients receive complete, seamless care for their spinal conditions.
- Dedicated facilities: Southwest Scoliosis and Spine Institute provides patients with a safe and comfortable environment.
Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat their spine patients. Southwest Scoliosis and Spine Institute with offices in Dallas, Plano, and Frisco, Texas offers cutting-edge technology, comprehensive care, and dedicated facilities to ensure the best possible care for their patients. Get in touch with us today to schedule an appointment.
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If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.