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Bone Graft Substitutes for Anterior Lumbar Interbody Fusion
Author(s) -
Mobbs Ralph J,
Chung Mina,
Rao Prashanth J
Publication year - 2013
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12030
Subject(s) - medicine , iliac crest , arthrodesis , surgery , lumbar , spinal fusion , bone morphogenetic protein , pathology , biochemistry , chemistry , alternative medicine , gene
The procedure of anterior lumbar interbody fusion ( ALIF ) is commonly performed on patients suffering from pain and/or neurological symptoms associated with disorders of the lumbar spine caused by disc degeneration and trauma. Surgery is indicated when prolonged conservative management proves ineffective. Because an important objective of the ALIF procedure is solid arthrodesis of the degenerative spinal segment, bone graft selection is critical. Iliac crest bone grafts ( ICBG ) remain the “gold standard” for achieving lumbar fusion. However, patient dissatisfaction stemming from donor site morbidity, lengthier operating times and finite supply of ICBG has prompted a search for better alternatives. Here presented is a literature review evaluating available bone graft options assessed within the clinical setting. These options include autografts, allograft‐based, synthetic and cell‐based technologies. The emphasis is on the contentious use of recombinant human bone morphogenetic proteins, which is in widespread use and has demonstrated both significant osteogenic potential and risk of complications.

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