Category: Spine | Author: Stefano Sinicropi | Date: November 29, 2021
A bone graft is a common tool used during the surgical process to help provide added stability to an area, and it’s especially common in certain types of spine surgeries. The most common spine surgery that involves a bone graft is a spinal fusion, and the graft ends up being the catalyst for the fusion process. In today’s blog, we decided to take a closer look at how bone grafts are used during spinal fusion to help correct a variety of issues.
What Is A Bone Graft?
Your skeleton is composed of what’s known as bone matrix, which is the hard material that helps to give your bones their strength. Inside this matrix are living cells that help to make new bone and maintain their matrix. When a fracture occurs, these cells can oftentimes repair the fracture and “fuse” the bone back together. However, if the fracture is too large, a bone graft may be needed to provide an area for this new bone to develop and fuse.
However, bone grafts aren’t just isolated to large fractures. Because of the way the bone cells work to build new healthy bone, they can also be used to grow bones in other areas of the body. The bone graft acts as a scaffolding system across which new bone grows and solidifies. When a bone graft is used in spinal surgery, it’s often inserted to connect two different bones so that they heal and fuse together.
Spinal fusion is a common operation when stability issues or excessive spinal segmental movement is causing significant pain. If you’re dealing with degenerative spinal discs that are causing disc herniation or shifting vertebral segments, or if scoliosis is causing a spinal curvature disorder, oftentimes the best solution is to fuse two adjacent spinal vertebrae together with the help of a bone graft. Over time, the bone graft ends up welding the two segments into one to limit excessive movement and vertebral shifting.
As you might imagine, bone grafting doesn’t immediately fuse the two bones together. The graft acts as a bridge and works to stimulate new bone growth that eventually ends up connecting the two pieces of bone to create long-term strength and stability.
Types Of Spinal Bone Grafts
In general, there are two types of bone grafts, as you can use real bone or an artificial graft substitute. When real bone is harvested from the patient to be used as a bone graft, it’s known as an autograft, and when it’s harvested from a donor, it’s known as an allograft. In most instances, an autograft is the preferred type of graft because it contains the patient’s own cells, proteins, genetic markers and calcified matrix, which the body recognizes more easily when stimulating new bone growth. Typically an autograft has a higher rate of fusion success and a reduced risk of infection likelihood. However, the main drawback is that a person will have post-op pain at the location from which the graft was harvested.
If an autograft can’t safely be performed, or the potential risks of sectioning off a graft from the patient outweigh the benefits, an allograft may be harvested. Allografts are typically harvested from cadavers that have been donated for medicinal purposes. These grafts obviously do not have living cells in them, which makes them less effective at fusing the site, but they can typically still provide enough of a bridge for the patient’s own body to use the graft to create the fusion.
In some situations, a bone graft substitute is preferred to an autograft or allograft. Bone graft substitutes are man-made versions of the natural graft and mimic the healing that would occur if human bone was inserted into the site. There are a number of different artificial bone graft substitutes, including demineralized bone matrix (DBM), ceramic-based bone graft extenders and bone morphogenetic proteins that can all help to stimulate new bone growth and fuse two structures together. Your spine specialist can walk you through these artificial options and their benefits and potential drawbacks should they believe this is the best route to pursue.
So if you’re plagued by back pain caused by excessive movement, a loss in spinal stability or vertebral shifting, ask your spine specialist if a fusion procedure with the help of a bone graft is right for you. For more information, or for help with your spinal issue, reach out to Dr. Sinicropi’s office today.