Abstract
Bone grafts have been used for decades to achieve successful bone fusion in spinal surgeries. Autograft is the most effective bone graft due to the properties of osteogenesis, osteoconduction, and osteoinduction. However, autograft may not always be available in sufficient quantities, and harvesting may cause patient morbidity. Various ceramic and non-ceramic bone graft extenders have been introduced to limit the need for autograft harvest. These bone substitutes have rapidly evolved in recent years with technological and industrial advancements. Spinal surgeons should closely follow new trends in this industry to achieve the best outcomes for their patients.
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References
Dimar JR, Glassman SD, Burkus KJ et al (2006) Clinical outcomes and fusion success at 2 years of single-level instrumented posterolateral fusions with recombinant human bone morphogenetic protein-2/compression resistant matrix versus iliac crest bone graft. Spine 31:2534–2539
Epstein NE (2006) A preliminary study of the efficacy of Beta Tricalcium Phosphate as a bone expander for instrumented posterolateral lumbar fusions. J Spinal Disord Tech 19:424–429
Vaccaro AR, Whang PG, Patel T et al (2008) The safety and efficacy of OP-1 (rhBMP-7) as a replacement for iliac crest autograft for posterolateral lumbar arthrodesis: minimum 4-year follow-up of a pilot study. Spine J 8:457–465
Jorgenson SS, Lowe TG, France J et al (1994) A prospective analysis of autograft versus allograft in posterolateral lumbar fusion in the same patient. A minimum of 1-year follow-up in 144 patients. Spine 19:2048–2053
Acebal-Cortina G, Suárez-Suárez MA, García-Menéndez C et al (2011) Evaluation of autologous platelet concentrate for intertransverse lumbar fusion. Eur Spine J 20 Suppl 3:361–366
Dai LY, Jiang LS (2008) Single-level instrumented posterolateral fusion of lumbar spine with beta-tricalcium phosphate versus autograft: a prospective, randomized study with 3-year follow-up. Spine 33:1299–1304
Kanayama M, Hashimoto T, Shigenobu K et al (2006) A prospective randomized study of posterolateral lumbar fusion using osteogenic protein-1 (OP-1) versus local autograft with ceramic bone substitute: emphasis of surgical exploration and histologic assessment. Spine 31:1067–1074
Chen WJ, Tsai TT, Chen LH et al (2005) The fusion rate of calcium sulfate with local autograft bone compared with autologous iliac bone graft for instrumented short-segment spinal fusion. Spine 30:2293–2297
Alexander DI, Manson NA, Mitchell MJ (2001) Efficacy of calcium sulfate plus decompression bone in lumbar and lumbosacral spinal fusion: preliminary results in 40 patients. Can J Surg 44:262–266
Khan SN, Fraser JF, Sandhu HS et al (2005) Use of osteopromotive growth factors, demineralized bone matrix, and ceramics to enhance spinal fusion. J Am Acad Orthop Surg 13:129–137
Cinotti G, Patti AM, Vulcano A et al (2004) Experimental posterolateral spinal fusion with porous ceramics and mesenchymal stem cells. J Bone Joint Surg Br 86:135–142
Miller CP, Jegede K, Essig D et al (2012) The efficacies of 2 ceramic bone graft extenders for promoting spinal fusion in a rabbit bone paucity model. Spine 37:642–647
Berven S, Tay BK, Kleinstueck FS et al (2001) Clinical applications of bone graft substitutes in spine surgery: consideration of mineralized and demineralized preparations and growth factor supplementation. Eur Spine J 10 Suppl 2:S169-S177
Nickoli MS, Hsu WK (2014) Ceramic-based bone grafts as a bone grafts extender for lumbar spine arthrodesis: a systematic review. Global Spine J 4:211–216
Hsu CJ, Chou WY, Teng HP et al (2005) Coralline hydroxyapatite and laminectomy-derived bone as adjuvant graft material for lumbar posterolateral fusion. J Neurosurg Spine 3:271–275
Korovessis P, Koureas G, Zacharatos S et al (2005) Correlative radiological, self-assessment and clinical analysis of evolution in instrumented dorsal and lateral fusion for degenerative lumbar spine disease. Autograft versus coralline hydroxyapatite. Eur Spine J 14:630–638
Ploumis A, Albert TJ, Brown Z et al (2010) Healos graft carrier with bone marrow aspirate instead of allograft as adjunct to local autograft for posterolateral fusion in degenerative lumbar scoliosis: a minimum 2-year follow-up study. J Neurosurg Spine 13:211–215
Acharya NK, Kumar RJ, Varma HK et al (2008) Hydroxyapatite-bioactive glass ceramic composite as stand-alone graft substitute for posterolateral fusion of lumbar spine: a prospective, matched, and controlled study. J Spinal Disord Tech 21:106–111
Singh K, Smucker JD, Gill S et al (2006) Use of recombinant human bone morphogenetic protein-2 as an adjunct in posterolateral lumbar spine fusion: a prospective CT-scan analysis at one and two years. J Spinal Disord Tech 19:416–423
Park DK, Kim SS, Thakur N et al (2013) Use of recombinant human bone morphogenetic protein-2 with local bone graft instead of iliac crest bone graft in posterolateral lumbar spine arthrodesis. Spine 38:E738-E747
Epstein NE (2008) An analysis of noninstrumented posterolateral lumbar fusions performed in predominantly geriatric patients using lamina autograft and beta tricalcium phosphate. Spine J 8:882–887
Blom AW, Cunningham JL, Hughes G et al (2005) The compatibility of ceramic bone graft substitutes as allograft extenders for use in impaction grafting of the femur. J Bone Joint Surg Br 87:421–425
Turner TM, Urban RM, Gitelis S et al (2003) Resorption evaluation of a large bolus of calcium sulfate in a canine medullary defect. Orthopedics 26(5 Suppl):s577–s579
Hadjipavlou AG, Simmons JW, Yang J et al (2000) Plaster of Paris as an osteoconductive material for interbody vertebral fusion in mature sheep. Spine 25:10–15
Sidqui M, Collin P, Vitte C (1995) Osteoblast adherence and resorption activity of isolated osteoclasts on calcium sulphate hemihydrate. Biomaterials 16:1327–1332
Coetzee AS (1980) Regeneration of bone in the presence of calcium sulfate. Arch Otolaryngol 106:405–409
Hurlbert RJ, Alexander D, Bailey S et al (2013) rhBMP-2 for posterolateral instrumented lumbar fusion: a multicenter prospective randomized controlled trial. Spine 38:2139–2148
Jenis LG, Banco RJ (2010) Efficacy of silicate-substituted calcium phosphate ceramic in posterolateral instrumented lumbar fusion. Spine 35:E1058–E1063
Johnsson R, Strömqvist B, Aspenberg P (2002) Randomized radiostereometric study comparing osteogenic protein-1 (BMP-7) and autograft bone in human noninstrumented posterolateral lumbar fusion: 2002 Volvo Award in clinical studies. Spine 27:2654–2661
Kasai Y, Takegami K, Uchida A (2003) Mixture ratios of local bone to artificial bone in lumbar posterolateral fusion. J Spinal Disord Tech 16:31–37
Frantzén J, Rantakokko J, Aro HT et al (2011) Instrumented spondylodesis in degenerative spondylolisthesis with bioactive glass and autologous bone: a prospective 11-year follow-up. J Spinal Disord Tech 24:455–461
Lee KB, Taghavi CE, Hsu MS et al (2010) The efficacy of rhBMP-2 versus autograft for posterolateral lumbar spine fusion in elderly patients. Eur Spine J 19:924–930
Carreon LY, Glassman SD, Djurasovic M et al (2009) RhBMP-2 versus iliac crest bone graft for lumbar spine fusion in patients over 60 years of age: a cost-utility study. Spine 34:238–243
Vaccaro AR, Stubbs HA, Block JE (2007) Demineralized bone matrix composite grafting for posterolateral spinal fusion. Orthopedics 30:567–570
Sassard WR, Eidman DK, Gray PM et al (2000) Augmenting local bone with Grafton demineralized bone matrix for posterolateral lumbar spine fusion: avoiding second site autologous bone harvest. Orthopedics 23:1059–1064
Urist MR, Strates BS (2009) The classic: bone morphogenetic protein. Clin Orthop Relat Res 467:3051–3062
Kiely PD, Brecevich AT, Taher F et al (2014) Evaluation of a new formulation of demineralized bone matrix putty in a rabbit posterolateral spinal fusion model. Spine J 14:2155–2163
Hart R, Komzák M, Okál F et al (2014) Allograft alone versus allograft with bone marrow concentrate for the healing of the instrumented posterolateral lumbar fusion. Spine J 14:1318–1324
Chen CL, Liu CL, Sun SS et al (2006) Posterolateral lumbar spinal fusion with autogenous bone chips from laminectomy extended with OsteoSet. J Chin Med Assoc 69:581–584
Odri GA, Hami A, Pomero V et al (2012) Development of a per-operative procedure for concentrated bone marrow adjunction in postero-lateral lumbar fusion: radiological, biological and clinical assessment. Eur Spine J 21:2665–2672
Alsaleh KA, Tougas CA, Roffey DM et al (2012) Osteoconductive bone graft extenders in posterolateral thoracolumbar spinal fusion: a systematic review. Spine 37:E993-E1000
Gupta A, Kukkar N, Sharif K et al (2015) Bone graft substitutes for spine fusion: a brief review. World J Orthop 6:449–456
Dimar JR 2nd, Glassman SD, Burkus JK et al (2009) Clinical and radiographic analysis of an optimized rhBMP-2 formulation as an autograft replacement in posterolateral lumbar spine arthrodesis. J Bone Joint Surg Am 91:1377–1386
Epstein NE (2009) Beta tricalcium phosphate: observation of use in 100 posterolateral lumbar instrumented fusions. Spine J 9:630–638
Glassman SD, Dimar JR 3rd, Burkus K et al (2007) The efficacy of rhBMP-2 for posterolateral lumbar fusion in smokers. Spine 32:1693–1698
Glassman SD, Dimar JR, Carreon LY (2005) Initial fusion rates with recombinant human bone morphogenetic protein-2/compression resistant matrix and a hydroxyapatite and tricalcium phosphate/collagen carrier in posterolateral spinal fusion. Spine 30:1694–1698
Dawson E, Bae HW, Burkus JK et al (2009) Recombinant human bone morphogenetic protein-2 on an absorbable collagen sponge with an osteoconductive bulking agent in posterolateral arthrodesis with instrumentation. A prospective randomized trial. J Bone Joint Surg Am 91:1604–1613
Arnold PM, Sasso RC, Janssen ME et al (2016) Efficacy of i-Factor bone graft versus autograft in anterior cervical discectomy and fusion: results of the prospective, randomized, single-blinded food and drug administration investigational device exemption study. Spine 41:1075–1083
Vaccaro AR, Anderson DG, Patel T et al (2005) Comparison of OP-1 Putty (rhBMP-7) to iliac crest autograft for posterolateral lumbar arthrodesis: a minimum 2-year follow-up pilot study. Spine 30:2709–2716
Vaccaro AR, Patel T, Fischgrund J et al (2004) A pilot study evaluating the safety and efficacy of OP-1 Putty (rhBMP-7) as a replacement for iliac crest autograft in posterolateral lumbar arthrodesis for degenerative spondylolisthesis. Spine 29:1885–1892
Buser Z, Brodke DS, Youssef JA et al (2016) Synthetic bone graft versus autograft or allograft for spinal fusion: a systematic review. J Neurosurg Spine 25:509–516
Tuchman A, Brodke DS, Youssef JA et al (2016) Iliac crest bone graft versus local autograft or allograft for lumbar spinal fusion: a systematic review. Global Spine J 6:592–606
Hostin R, O’Brien M, McCarthy I et al (2016) Retrospective study of anterior interbody fusion rates and patient outcomes of using mineralized collagen and bone marrow aspirate in multilevel adult spinal deformity surgery. Clin Spine Surg 29:E384-E388
Morris MT, Tarpada SP, Cho W (2018) Bone graft materials for posterolateral fusion made simple: a systematic review. Eur Spine J 27:1856–1867
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Lee, S., Morris, M.T., Essig, D.A., Cho, W. (2022). Spine Surgery—Part II: Ceramic and Non-ceramic Bone Substitutes: A Surgical Perspective. In: Choi, A.H., Ben-Nissan, B. (eds) Innovative Bioceramics in Translational Medicine II. Springer Series in Biomaterials Science and Engineering, vol 18. Springer, Singapore. https://doi.org/10.1007/978-981-16-7439-6_11
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DOI: https://doi.org/10.1007/978-981-16-7439-6_11
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