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Demineralized bone sponges support posterolateral lumbar fusion

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PHILADELPHIA — Compared to autograft bone, which is considered the gold standard graft material for spine fusion, demineralized bone matrix in the form of a sponge was associated with comparable fusion rates and less pain when used for posterolateral lumbar fusion, according to a presenter at the Philadelphia Spine Research Symposium, here.

B. Victor Yoon, MD, of Hospital for Special Surgery, in New York City, said demineralized bone matrix (DBM) is readily available, is safe and avoids any second site morbidity with posterolateral lumbar fusion.

“Demineralized bone sponge achieves satisfactory fusion even without the morbidity related to autograft harvesting,” Yoon said.

Autograft is the gold standard in these cases because there is no disease transmission, it is histocompatible and it properties are ideal for successful healing, Yoon said. However, there is a limited supply of a patient’s iliac crest autograft bone and the harvest processes may be associated with increased pain, morbidity and infection, he noted. On the other hand, DBM in a sponge form is easy to use and readily available, Yoon said.

Yoon and colleagues studied fusion rates using Osteosponge (Bacterin) DBM sponge in the clinical setting. They used the sponges in 122 patients who underwent posterolateral lumbar fusion and used 2.73 sponges, on average, per patient.

In all, 115 patients of the 122 patients achieved solid fusion for a 94.26% fusion rate, which Yoon said is comparable to fusion rates with autograft. VAS back pain scores decreased from 6.76 preoperatively to 2.85 postoperatively and VAS leg pain scores decreased from 6.09 preoperatively to 1.95 postoperatively (P < 0.01), he said. – by Robert Linnehan

Reference:

Yoon BV. Paper #S2.13. Presented at: Philadelphia Spine Research Symposium; Nov. 9-12, 2015; Philadelphia.

Disclosure: Yoon reports no relevant financial disclosures.