The Vault

Back Pain and Managing Back Pain Ron Friesenhahn Interview of Dr. Irvin Sahni of Seguin & New Braunfels TX
July 21, 2015
Bone Graft Substitutes
November 11, 2015

Bone Grafts

Bone grafts are bone or synthetic bone-like material transplanted from a donor site to a recipient site to form a bridge to facilitate bone fusion and healing. Grafts primarily assists bone strengthening to improve overall skeletal function. Once accepted by the patient, the grafting material provides the foundation and environment to allow the body to grow new bone and fuse a section of the skeleton together. Bone grafts are commonly used on post discectomy patients were damaged vertebrae caused by injury, deformity or disease is surgically removed.

Bone grafts act as fillers to form a bridge between two vertebral segments in the spine to obtain the fusion.

What are the available bone graft alternatives?

Bone grafts are transplanted tissues that are used to repair and rebuild diseased bones form your hips, knees or spine. It can also be used to repair bone loss caused by some types of fractures or cancers. Bone grafts are divided into three main categories based on where they are obtained. If it came from your own body, it is called Autograft. Allograft if it came from a donor or other person and Synthetic if it is entirely man-made.

Autograft bone graft is the term used when the patient’s own bone is used for the bone graft in orthopedic surgeries. The most common donor area is the iliac crest, which is located in the patient’s pelvis. The iliac crest autograft is considered to be the gold standard and is most often used as a bone graft in a spine fusion. The advantage of an autograph is the certainty of a 100% tissue match and its effectiveness. It contains the greatest amount of the patient’s own bone growing cells and protein, so there’s no possible complications such as tissue rejection or malformation. It is also considered as the safest to use due to the low risk of disease transmission. However, it does carry the risk of unwanted aftereffects such as postoperative pain at the donor site (the pelvis).

Allograft are bone harvested by a tissue bank from a cadaver, it is then disinfected and cleaned for use in medical procedures. It can be prepared in a number of different forms for use in a spine fusion. It comes in a variety of forms, including freeze-dried, fresh-frozen, cancellous chips, structural, and demineralized bone matrix (DBM). Compared to many of the bone graft substitutes in use today, it is relatively cheap and readily available. However, allograft incorporation into the patient bone is slower and less complete compared to an autograft. There is also a theoretical risk of disease transmission and lessened therapeutic effect because proteins and cells are withdrawn after disinfection procedures post harvesting.

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