However, the autogenous bone graft itself is an additional operation, and complications related to bone harvesting have been reported in up to 20.6% of cases. The reamer/irrigator/aspirator (RIA) technique was first developed to prepare long bones for intramedullary nail fixation. Recently, another source of autogenous cancellous bone from intramedullary canal is developed. In terms of bone healing, autogenous bone graft exhibits the best osteogenic potential and is still considered to be a gold standard by many authors. These numbers easily double or triple on a global basis, resulting in a shortage in the availability of donor tissue conventionally used in these bone reconstruction procedures. In the US, approximately 500,000 bone graft procedures are performed annually. The surgeon should understand the properties of each bone graft substitute to facilitate appropriate selection in each specific clinical situation.īone graft procedures have been increasingly used in traumatology, tumor surgery, spine surgery, infection, and revision arthroplasty. Conclusionĭespite tremendous efforts toward developing autograft alternatives, a single ideal bone graft substitute has not been developed. Recently, attention has been drawn to osteoinductive materials, such as demineralized bone matrix and bone morphogenetic proteins. However, they also have some disadvantages, such as brittle properties, variable rates of resorption, and poor performance in some clinical conditions. Synthetic porous substitutes share several advantages over allografts, including unlimited supply, easy sterilization, and storage. Synthetic bone substitutes consist of hydroxyapatite, tricalcium phosphate, calcium sulfate, or a combination of these minerals. This article aims to review the properties of the bone graft and various bone substitutes currently available in orthopedic surgery. However, due to limitations of supply and morbidity associated with autograft harvest, various bone substitutes have been considered. Underlying inflammatory or tumor disease.Autogenous bone graft is the gold standard bone graft material.Underlying neurological or neuromuscular disease.Patients who are going to have cemented and / or expansive screws, Peek boxes or another type of material other than Titanium.Patients who have had other types of implants placed, other than Cobalt Chrome bars and Titanium screws and interbody cages.Patients with mental disabilities that make it difficult for them to fill in the questionnaires.Patients who are expected to be unavailable for follow-up.The implants used in the surgery are Cobalt Chrome bars and Titanium screws and interbody cages.Present radiological tests, computed tomography and / or magnetic resonance imaging prior to surgery.(In the event that the patient's circumstances do not allow him to grant consent, this may be provided by the legal representative). Patients who provide their informed consent in writing.
In which the minimum number of levels to be instrumented is 5, that is, 4 intervertebral discs.
Why Should I Register and Submit Results?Īdult spinal deformity surgery is a complex procedure that involves many risks and complications.
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