Bone Graft and Spinal Fusion

In a spinal fusion, the bone graft is a porous material that acts as a "scaffold" or bridge to allow the bone (vertebrae) to heal together and in order to span the gap between the two vertebrae fusing them together. This provides structural support and eliminates the movement in that section of the spine.

The bone graft may include use of an autograft (patient’s own bone), an allograft (a cadaver bone) or a synthetic graft.

Bone Graft Considerations

There are a number of considerations to evaluate when deciding which type of bone graft to use. The main factors to be taken into account include:

The type of spinal fusion (e.g. ALIF, PLIF, TLIF, posterolateral fusion).
The number of levels (vertebrae) of the spine to be fused together. A one-level fusion involves two vertebrae (e.g. L4-L5). If more sections will be fused together, more bone graft will be needed.
Location of fusion – lumbar fusion (lower back) or cervical fusion (neck).
Potential complications associated with the bone graft product being used within the procedure, and with the procedure itself.
Patient risk factors for non-fusion (e.g. if patient is a smoker or has poor bone quality such as osteoporosis).
Surgeon experience and preference.

To date, using the patient’s own bone as the bone graft is considered the gold standard in spinal fusion. However, this is not always the best option for all patients. In an effort to reduce the surgical risks and possible complications with using the patient’s own bone, and to enhance rates of fusion, researchers have developed additional bone graft options.