Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: Bone graft extenders and substitutes as an adjunct for lumbar fusion

Update item information
Publication Type pre-print
School or College School of Medicine
Department Neurosurgery
Creator Dailey, Andrew T.
Other Author Kaiser, Michael G.; Groff, Michael W.; Watters III, William C.; Ghogawala, Zoher; Mummaneni, Praveen V.; Choudhri, Tanvir F.; Eck, Jason C.; Sharan, Alok; Wang, Jeffrey C.; Dhall, SanJay S.; Resnick, Daniel K.
Title Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: Bone graft extenders and substitutes as an adjunct for lumbar fusion
Date 2014-01-01
Description In an attempt to enhance the potential to achieve a solid arthrodesis and avoid the morbidity of harvesting autologous iliac crest bone (AICB) for a lumbar fusion, numerous alternatives have been investigated. The use of these fusion adjuncts has become routine despite a lack of convincing evidence demonstrating a benefit to justify added costs or potential harm. Potential alternatives to AICB include locally harvested autograft, calcium-phosphate salts, demineralized bone matrix (DBM), and the family of bone morphogenetic proteins (BMPs). In particular, no option has created greater controversy than the BMPs. A significant increase in the number of publications, particularly with respect to the BMPs, has taken place since the release of the original guidelines. Both DBM and the calciumphosphate salts have demonstrated efficacy as a graft extender or as a substitute for AICB when combined with local autograft. The use of recombinant human BMP-2 (rhBMP-2) as a substitute for AICB, when performing an interbody lumbar fusion, is considered an option since similar outcomes have been observed; however, the potential for heterotopic bone formation is a concern. The use of rhBMP-2, when combined with calcium phosphates, as a substitute for AICB, or as an extender, when used with local autograft or AICB, is also considered an option as similar fusion rates and clinical outcomes have been observed. Surgeons electing to use BMPs should be aware of a growing body of literature demonstrating unique complications associated with the use of BMPs.
Type Text
Publisher American Association of Neurological Surgeons
Volume 21
Issue 1
First Page 106
Last Page 132
Language eng
Bibliographic Citation Kaiser, M. G., Groff, M. W., Watters III, W. C., Ghogawala, Z., Mummaneni, P. V., Dailey, A. T., Choudhri, T. F., Eck, J. C., Sharan, A., Wang, J. C., Dhall, S. S., & Resnick, D. K. (2014). Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: Bone graft extenders and substitutes as an adjunct for lumbar fusion. Journal of Neurosurgery: Spine, 21(1), 106-32.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 2,206,706 bytes
Identifier uspace,18804
ARK ark:/87278/s61v8q22
Setname ir_uspace
Date Created 2014-08-06
Date Modified 2014-08-06
ID 712618
Reference URL https://collections.lib.utah.edu/ark:/87278/s61v8q22
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