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Ceramic Biologics for Bony Fusion—a Journey from First to Third Generations

  • Updates In Spine Surgery—Techniques, Biologics, and Non-Operative Management (W Hsu, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

To provide information on characteristics and use of various ceramics in spine fusion and future directions.

Recent Findings

In most recent years, focus has been shifted to the use of ceramics in minimally invasive surgeries or implementation of nanostructured surface modification features to promote osteoinductive properties. In addition, effort has been placed on the development of bioactive synthetics. Core characteristic of bioactive synthetics is that they undergo change to simulate a beneficial response within the bone. This change is based on chemical reaction and various chemical elements present in the bioactive ceramics. Recently, a synthetic 15-amino acid polypeptide bound to an anorganic bone material which mimics the cell-binding domain of type-I collagen opened a possibility for osteogenic and osteoinductive roles of this hybrid graft material.

Summary

Ceramics have been present in the spine fusion arena for several decades; however, their use has been limited. The major obstacle in published literature is small sample size resulting in low evidence and a potential for bias. In addition, different physical and chemical properties of various ceramics further contribute to the limited evidence. Although ceramics have several disadvantages, they still hold a great promise as a value-based graft material with being easily available, relatively inexpensive, and non-immunogenic.

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Authors and Affiliations

  1. Department Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Brandon Ortega, Carson Gardner, Sidney Roberts, Andrew Chung, Jeffrey C. Wang & Zorica Buser

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  1. Brandon Ortega
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  2. Carson Gardner
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Correspondence to Zorica Buser.

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Conflict of Interest

No conflicts of interest for the current study. Disclosures outside of submitted work: Brandon Ortega, Carson Gardner, Sidney Roberts, and Andrew Chung have no disclosures. Jeffrey Wang: royalties—Biomet, Seaspine, Amedica, DePuy Synthes; investments/options—Bone Biologics, Pearldiver, Electrocore, Surgitech; board of directors—North American Spine Society, AO Foundation (20,000 honorariums for board position, plus travel for board meetings), Cervical Spine Research Society; editorial boards—Spine, the Spine Journal, Clinical Spine Surgery, Global Spine Journal; fellowship funding (paid directly to institution)—AO Foundation. Zorica Buser: consultancy—Cerapedics, The Scripps Research Institute, Xenco Medical (past), AO Spine (past); research support—SeaSpine (past, paid to the institution), Next Science (paid directly to institution), Motion Metrics (paid directly to institution); North American Spine Society—committee member; Lumbar Spine Society—co-chair research committee; AOSpine Knowledge Forum Degenerative—associate member; AOSNA Research Committee—committee member.

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Ortega, B., Gardner, C., Roberts, S. et al. Ceramic Biologics for Bony Fusion—a Journey from First to Third Generations. Curr Rev Musculoskelet Med 13, 530–536 (2020). https://doi.org/10.1007/s12178-020-09651-x

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