ABSTRACT
Bone graft substitutes are widely used in the field of orthopedics and are extensively used to promote vertebral fusion. Fusion is the most common technique in spine surgery and is used to treat morbidities and relieve discomfort. Allograft and autograft bone substitutes are currently the most commonly used bone grafts to promote fusion. These approaches pose limitations and present complications to the patient. Numerous alternative bone graft substitutes are on the market or have been developed and proposed for application. These options have attempted to promote spine fusion by enhancing osteogenic properties. In this review, we reviewed biology of spine fusion and the current advances in biomedical materials and biological strategies for application in surgical spine fusion. Our findings illustrate that, while many bone graft substitutes perform well as bone graft extenders, only osteoinductive proteins (recombinant bone morphogenetic proteins-2 and osteogenic protein-1) provide evidence for use as both bone enhancers and bone substitutes for specific types of spinal fusion. Tissue engineered hydrogels, synthetic polymer composites and viral based gene therapy also holds the potential to be used for spine fusion in future, though warrants further investigation to be used in clinical practice.
Subject(s)
Arthrodesis/methods , Decompression, Surgical/methods , Endoscopy/methods , Spinal Cord Compression/diagnosis , Spinal Cord Compression/surgery , Adult , Atlanto-Occipital Joint , Cervical Atlas , Cranial Fossa, Posterior/pathology , Cranial Fossa, Posterior/surgery , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging/methods , Physical Examination/methods , Recovery of Function , Risk Assessment , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
This annual 5-day Continued Medical Education event featured the latest in new treatment strategies and techniques for orthopedists, neurosurgeons, physiatrists, primary care providers and other professionals involved in treating patients with spinal disorders. This year's program content focused on: minimally invasive surgery, motion-preservation surgery, nonoperative spine care, value (quality/cost) and maintenance of certification self-assessment examination.
