Bone Grafts and Bone Graft Substitutes

Abstract

Bone grafts or substitutes are used in spinal surgery to fill defects, to bridge defects or to promote spondylodesis. The physiological process is similar to that of fracture healing and incorporates the same spatial and temporal factors. The ideal material should provide osteogenetic, osteoinductive and osteoconductive properties. The traditional autologous bone grafts are probably still considered the “golden standard”, but the problems associated with them bring up the need for substitutes. One alternative is the acquirance of allogeneic or xenogeneic bone grafts, which have specific problems of their own, which limit their use. The other aspect is the use of bone substitutes, which come in a growing variety of materials, shapes and application forms. Currently, none of these substitutes unite all of the prerequisites shown above, but they have the advantage of unlimited supply without causing additional problems such as donor site morbidity. And the combination of such substitutes as scaffold with the utilization of growth factors and mesenchymal stem cells brings with them a completely new array of possibilities.