Bone Graft Alternatives in Spinal Fusion

Abstract

Hundreds of thousands of spinal fusions are performed each year in the United States, and some form of bone graft material is used in virtually every case. Although successful arthrodesis depends on many biologic and mechanical factors, union largely depends on the proper functioning of the bone graft material.

This OKO module discusses autologous bone grafts and their alternatives, including allografts, demineralized bone matrix (DBM), bone marrow aspirates, ceramics, and bone morphogenetic protein (BMP), including rhBMP-2 and rhBMP-7. The authors outline the basic requirements of bone graft material and provide a thorough discussion of each alternative material's advantages, disadvantages, and clinical use.

They also discuss the efficacy of bone graft materials for specific functions, review the anatomic locations and mechanical and spatial environments in which bone grafts are used, and discusses IDE trials and safety considerations, including off-label use.

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