The art of bone grafting

Current Opinion in Orthopaedics

Volumn 18, Issue 3, 2007, Pages 226-233

  Dimar, John R ^a   Glassman, Steven D ^a  

^a University of Louisville School of Medicine   (United States)

Author keywords

Bone grafting; Bone morphogenetic protein; Osteoconductivity; Osteoinductivity; Spinal arthrodesis

Indexed keywords

BIOMATERIAL; CALCIUM; CALCIUM PHOSPHATE; CALCIUM PHOSPHATE CERAMIC; CALCIUM PHOSPHATE DIBASIC; CALCIUM SULFATE; COLLAGEN SPONGE; HYDROXYAPATITE; RECOMBINANT BONE MORPHOGENETIC PROTEIN 2; RECOMBINANT OSTEOGENIC PROTEIN 1;

AUTOGRAFT; BIOMECHANICS; BONE DEMINERALIZATION; BONE DEVELOPMENT; BONE GRAFT; CLINICAL TRIAL; DRUG DOSE INCREASE; GENETIC ENGINEERING; HUMAN; ILIAC CREST; INTERVERTEBRAL DISK DEGENERATION; INTERVERTEBRAL DISK HERNIA; NONHUMAN; POSTEROLATERAL SPINE FUSION; PRIORITY JOURNAL; REVIEW; SPINE FUSION; SPONDYLOLISTHESIS; TRANSFORAMINAL LUMBAR INTERBODY FUSION; TREATMENT OUTCOME; WEIGHT BEARING;

EID: 34247272567     PISSN: 10419918     EISSN: None     Source Type: Journal    
DOI: 10.1097/BCO.0b013e328112f35d     Document Type: Review

References (51)

1. Albee FH. Transplantation of a portion of the tibia into the spine for Pott's disease: A preliminary report. JAMA 1911; 42:885-886.
2. Hibbs RA. An operation for progressive spinal deformities: a preliminary report of three cases from the service of the Orthopaedic Hospital. New York Med J 1911; 93:1013-1016.
3. Urist MR. Bone: formation by autoinduction. Clin Orthop Relat Res 2002; (395):4-10.
4. Cheng H, Jiang W, Phillips FM, et al. Osteogenic activity of the fourteen types of human bone morphogenic proteins (BMPs). J Bone Joint Surg Am 2003; 85A:1544-1552.
5. Wozney JM. The bone morphogenetic proteins and their gene expression. In: Noda M, editor. Molecular and cellular biology of bone. San Diego: Academic Press; 1993. pp. 131-167.
6. Burkus JK, Sandhu HS, Gornet MF, Longley MC. Use of rhBMP-2 in combination with structural cortical allografts: clinical and radiographic outcomes in anterior lumbar spinal surgery. J Bone Joint Surg Am 2005; 87-A:1205-1212.
7. Dimar JR, Glassman SD, Burkus KJ, Carreon LY. Clinical outcomes and fusion success at two years of single-level instrumented posterolateral fusions with recombinant human bone morphogenetic protein-2/compression resistant matrix versus iliac crest bone graft. Spine 2006; 31:2534-2539. The authors present the 2-year results of 98 patients enrolled in a randomized prospective study comparing ICBG with rhBMP-2 with a ceramic impregnated collagen sponge in instrumented single-level posterolateral spinal fusions. All patients were evaluated with plain radiographs and CT scans and outcome measures. The fine-cut CT scans demonstrated a fusion rate of 73.3% in patients who received ICBG and 90.6% in those who received rhBMP-2. Both groups exhibited significant improvements in clinical outcome over all time intervals. The rhBMP-2 group showed significantly lower blood loss, operative time and no graft site morbidity.
8. Carreon LY, Glassman SD, Anekstein Y, Puno RM. Platelet Gel (AGF) fails to increase fusion rates in instrumented posterolateral fusions. Spine 2005; 30:E243-E246.
9. Castro FP Jr. Role of activated growth factors in lumbar spinal fusions. J Spinal Disord Tech 2004; 17:380-384.
10. Hee HT, Majd ME, Holt RT, Myers L. Do autologous growth factors enhance transforaminal lumbar interbody fusion? Eur Spine J 2003; 12:400-407.
11. Jenis LG, Blanco RJ, Kwon B. A prospective study of autologous growth factors (AGF) in lumbar interbody fusion. Spine 2006; 6:14-20.
12. McKay WF, Peckham S, Scifert J. Biologics to promote spinal fusion. In: Medtronic Sofamor Danek Spine Technology Handbook; 2006. pp. 241-279. This is a comprehensive monograph of the history, preclinical development, and recent clinical studies of the use of biologics in spinal fusions, particularly the BMP family of proteins.
13. Urist MR, Mikulski A, Lietze A. Solubilized and insolubilized bone morphogenic protein. Proc Natl Acad Sci U S A 1979; 76:1828-1832.
14. Boden SD. Overview of the biology of lumbar spine fusion and principles for selecting a bone graft substitute. Spine 2002; 27 (16S):S26-S31.
15. Bono CM, Lee CK. Critical analysis of trends in fusion for degenerative disc disease over the past 20 years: influence of techniques on fusion rate and clinical outcome. Spine 2004; 29:455-463.
16. Kuhne JH, Bartl R, Frisch B, et al. Bone formation in coralline hydroxyapatite: effect of pore size studied in rabbits. Acta Orthop Scand 1994; 65:246-252.
17. Linovitz RJ, Peppers TA. Use of an advanced formulation of beta-tricalcium phosphate as a bone extender in interbody lumbar fusion. Orthopedics 2002; 25 (5S):S585-S589.
18. Meadows GR. Adjunctive use of ultraporous beta-tricalcium phosphate bone void filler in spinal arthrodesis. Orthopedics 2002; 25 (5S):S579-S584.
19. Armstrong DG, Findlow AH, Oyibo SO, Boulton AJ. The use of absorbable antibiotic impregnated calcium sulfate pellets in the management of diabetic foot infections. Diabet Med 2001; 18:942-943.
20. Glazer PA, Spencer UM, Alkalay RN, Schwardt J. In vivo evaluation of calcium sulfate a bone graft substitute for lumbar spinal fusion. Spine J 2001; 1:395-401.
21. Kraiwattanapong C, Boden SD, Louis-Ugbo J, et al. Comparison of Healos/bone marrow to INFUSE (rhBMP-2/ACS) with a collagen-ceramic sponge bulking agents as graft substitutes for lumbar spine fusion. Spine 2005; 30:1001-1007.
22. Jaw RY, Keesling J, Wironen JF. The level of BMP-2/4 extracted from human bone correlates with the osteoinductive potential of that bone in vivo. Paper presented at the 25th Annual Meeting of the American Association of Tissue Banks, Washington DC; 2001.
23. Tlakikawa S, Bauer TW, Kambic H, Togawa D. Comparative evaluation of the osteoinductivity of two formulations of human demineralized bone matrix. J Biomed Mater Res 2003; 65:37-42.
24. Traianedes K, Russell JL, Edwards JT, et al. Donor age and gender effects on osteoinductivity of demineralzed bone matrix. J Biomed Mater Res 2004; 70B:21-29.
25. Cammisa FP Jr, Lowery G, Garfin SR, et al. Two-year fusion rate equivalency between Grafton DBM Gel and autograft in posterolateral spine fusion: a prospective controlled trial employing a side-by-side comparison in the same patient. Spine 2004; 29:660-666.
26. Sassard WE, Eidman DK, Gray PM, et al. Augmenting local bone with Grafton demineralized bone matrix for posterolateral lumbar spine fusion: avoiding second site autologous bone harvest. Orthopedics 2000; 23:1059-1064.
27. Cook SD, Dalton JE, Prewett AB, Whitecloud TS 3rd. In vivo evaluation of recombinant human osteogenic protein (rhOP-1) implants as a bone graft substitute for spinal fusions. Spine 1994; 19:1655-1663.
28. Cunningham BW, Kanayama M, Parker LM, et al. Osteogenic protein versus autogenous interbody arthrodesis in the sheep thoracic spine: a comparative endoscopic study using the Bagby and Kuslich interbody fusion device. Spine 1999; 24:509-518.
29. Cunningham BW, Shimamoto N, Sefter JC, et al. Osteointegration of autograft versus osteogenic protein-1 in posterolateral spinal arthrodesis: emphasis on the comparative mechanism of bone induction. Spine J 2002; 2:11-24.
30. Vaccaro AR, Patel T, Fischgrund J, et al. A pilot safety and efficacy study of OP-1 putty (rhBMP-7) as an adjunct to iliac crest autograft in posterolateral lumbar fusions. Euro Spine J 2003; 12:495-500.
31. Vaccaro AR, Patel T, Fischgrund J, et al. A two year follow-up pilot study evaluating the safety and efficacy of OP-1 putty (rhbmp-7) as an adjunct to iliac crest autograft in posterolateral lumbar fusions. Eur Spine J 2005; 14:623-629.
32. Kanayama M, Hashimoto T, Shigenobu K, et al. A prospective randomized study of posterolateral lumbar fusion using osteogenic protein-1 (OP-1) versus local autograft with ceramic bone substitute. Spine 2006; 31:1067-1074. The authors present the results of a randomized human trial in 19 patients with degenerative spondylolisthesis treated with either rhBMP-7 (OP-1) putty or autograft/hydroxyapatite/tricalcium phosphate granules. Based on CT scan evaluations seven of nine OP-1 patients and nine of 10 autograft patients achieved fusion. On surgical exploration, four of seven OP-1 and seven of nine autograft patients were fused. The authors concluded that although OP-1 was successful in inducing new bone formation, its fusion success was only 57%.
33. Boden SD, Martin GJ Jr, Horton WC, et al. Laparoscopic anterior spinal arthrodesis with rhBMP-2 in a titanium interbody threaded cage. J Spinal Disord 1998; 11:95-101.
34. Boden SD, Schimandle JH, Hutton WC, Chen MI. 1995 Volvo Award in basic sciences. The use of an osteoinductive growth factor for lumbar spinal fusion. Part I: Biology of spinal fusion. Spine 1995; 20:2626-2632.
35. Boden SD, Schimandle JH, Hutton WC. 1995 Volvo Award in basic sciences. The use of an osteoinductive growth factor for lumbar spinal fusion. Part II: Study of dose, carrier, and species. Spine 1995; 20:2633-2644.
36. Schimandle JH, Boden SD, Hutton WC. Experimental spinal fusion with recombinant human bone morphogenetic protein-2. Spine 1995; 20:1326-1337.
37. Sandhu HS, Kanim LE, Kabo JM, et al. Evaluation of rhBMP-2 with an OPLA carrier in a canine posterolateral (transverse process) spinal fusion model. Spine 1995; 20:2669-2682.
38. Sandhu HS, Kanim LE, Kabo JM, et al. Effective doses of recombinant human bone morphogenetic protein-2 in experimental spinal fusion. Spine 1996; 21:2115-2122.
39. Sandhu HS, Kanim LE, Toth JM, et al. Experimental spinal fusion with recombinant human bone morphogenetic protein-2 without decortication of osseous elements. Spine 1996; 22:1171-1180.
40. Boden SD,Martin GJJr, Morone M, et al. The use of coralline hydroxyapatite with bone marrow, autogenous bone graft, or osteoinductive bone protein extract for posterolateral lumbar spine fusion. Spine 1999; 24: 320-327.
41. Martin GJ Jr, Boden SD, Marone MA, et al. Posterolateral intertransverse process spinal arthrodesis with rhBMP-2 in a nonhuman primate: important lessons learned regarding dose, carrier, and safety. J Spinal Disord 1999; 12:179-186.
42. Burkus JK, Gornet MF, Dickman CA, Zdeblick TA. Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages. J Spinal Disord Tech 2002; 15:337-349.
43. Burkus JK, Transfeldt EE, Kitchel SH, et al. Clinical and radiographic outcomes of anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2. Spine 2002; 27:2396-2408.
44. Burkus JK, Sandhu HS, Gornet MF. Influence of rhBMP-2 on the healing patterns associated with allograft interbody constructs in comparison with autograft. Spine 2006; 31:775-781. This is the second multicenter study comparing allograft threaded dowels combined with either autograft or rhBMP-2/ACS. A total of 131 patients were randomized into these two study groups and followed for 2 years with serial CT scans and an outcome battery. The investigational group showed significantly less blood loss, shorter surgical time, hospital stays and fusion rates and observed transient zones of remodeling all healed. Additionally, the investigational group exhibited significantly better SF-36, leg and back pain scores. The study demonstrates that threaded allograft dowels combined with rhBMP2/ACS eliminate graft site pain and offered significantly (P<0.001) higher fusion rates.
45. Pradhan BB, Bae HW, Dawson EG, et al. Graft resorption with the use of bone morphogenetic protein: lessons from anterior lumbar interbody fusion using femoral ring allografts and recombinant human bone morphogenetic protein-2. Spine 2006; 31:277-284. The authors report the prospective results of 36 patients treated with anterior interbody fusions combining stand-alone allograft femoral rings with rhBMP-2 or the control group of 27 individuals in whom autograft was combined with allograft femoral rings. Radiographic comparison of the two groups identified that 36% (10/27) of the autograft group failed to fuse compared with a much higher fusion failure of 56% (five of nine) in the rhBMP-2 group. The rhBMP-2 group's CT scans demonstrated aggressive graft resorption and fragmentation, resulting in nonunions causing the early termination of this study arm.
46. Boden SD, Kang J, Sandhu H, Heller JG. Use of recombinant human bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective, randomized clinical pilot trial. Spine 2002; 27:2662-2673.
47. Dimar JR, Glassman SD, Burkus JK, et al. A large-scale, level 1, clinical and radiographic analysis of an optimized rhBMP-2 formulation as an autograft replacement in posterolateral lumbar spine fusion. Paper presented at the 40th Annual Meeting of the North American Spine Society; Seattle, WA; 2006. The authors present the 2-year results of a randomized, prospective study of instrumented single-level posterolateral fusion comparing ICBG with a 40mg dose of rhBPM-2/CRM. Demographic data demonstrated significantly (P<0.001) less blood loss (343 versus 449cm3) and operative time (2.5 versus 2.9 h) in the investigational group. Plain radiographs demonstrated an 86.8% fusion rate in the ICBG group compared with an rhBMP-2 fusion rate of 94.9%, while CT scans showed fusion rates of 82.6 and 92.6%. Outcome measures demonstrated similar improvements over all time intervals. Sixty-four percent of the ICBG group still reported graft site pain 2 years later. The authors concluded that the rhBMP-2/CRM was an effective bone graft replacement.
48. Singh K, Smucker JD, Boden SD. Use of recombinant human bone morphogenetic protein-2 as an adjunct in posterolateral lumbar spine fusion. J Spinal Disord Tech 2006; 19:416-423.
49. Potter BK, Freedman BA, Verwiebe EG, et al. Transforaminal lumbar interbody fusion: clinical and radiographic results and complications in 100 consecutive patients. J Spinal Dis Tech 2005; 18:337-346.
50. Schwender JD, Holly LT, Rouben DP, Foley KT. Minimally invasive transforaminal lumbar interbody fusion (TLIF). J Spinal Dis Tech 2005; 18 (1S):1-6.
51. Villavicencio AT, Burneikiene S, Nelson EL, et al. Safety of transforminal lumbar interbody fusion and intervertebral recombinant human bone morphogenetic protein-2. J Neurosurg Spine 2005; 3:436-443.