A new study published in Spine examines bone graft substitutes for one- and two-level anterior cervical discectomy and fusion.
The study authors reviewed 22 published articles on patients who underwent ACDF with bone graft substitute and at least six months follow-up. The materials examined in the studies included ceramic-based synthetic bone grafts, allografts, bone morphogenetic proteins, mesenchymal stem cells and bone marrow aspirate. Study authors found:
1. Bone morphogenetic proteins had a 100 percent fusion rate regardless of study length and whether the surgeon used additional bone graft substitutes.
2. Ceramic-based synthetics reported 80.5 percent fusion rate, the lowest fusion rate among all bone graft substitutes examined.
3. Allograft had an 87.3 percent fusion rate when used alone. One study, Kim et al, was an outliner for allograft fusion rates and when removed, the average fusion rate for allograft alone was 92.5 percent.
4. All grafts showed improved postoperative outcomes, although dysphagia was reported at higher rates in the BMP group.
5. Study authors concluded that allograft was associated with the lowest cost spinal fusions with similar fusion rates and outcomes to the other bone graft substitutes.