COMMON BONE GRAFTING PROCEDURES AND HEALING ENVIRONMENTS
Mechanical stability and bone formation are critical to achieving a successful outcome for surgical procedures involving bone grafting. Bone grafts are used in a variety of surgical procedures, each with unique healing environments and varying degrees of complexity.
SPINE AND SPINAL FUSION
Reasons for surgery:
- Mechanical back pain
- Neurologic impairment
- Trauma
- Deformity
- Tumor
- Spinal fusion
Common bone grafting procedures:
- Interbody spinal fusion
- Posterolateral spinal fusion
- Corpectomy
- Sacroiliac spinal fusion
General healing environments:
- Spinal fusion are challenging healing environments.
- Disc space, surface area, and load increase from cervical to lumbar spine.
- Posterolateral fusions require larger graft volume and have minimal bone cell access.
- Adding surgical levels increases the complexity of the procedure.
orthopaedic
Reasons for surgery:
- Trauma
- Unstable joints
- Pain
- Loss of function
- Tumor
Common bone grafting procedures:
- Open reduction with internal fixation
- Segmental defect repair
- Joint fusions
- Repair from tumor or cyst resection
General healing environments:
- Open fractures are difficult to heal due to contamination and potential for infection.
- Limited soft tissue coverage around the tibia leads to a lack of bone-forming cells.
- Some areas, such as the foot, ankle, and tibia must withstand heavy loads.
- Joint fusions are challenging environments that require large volumes of graft material.
There are currently more than 200 different bone grafts available to surgeons today. There are distinct differences in technology, materials, mechanisms of action, indications, and clinical evidence for these bone grafting options.