The Role of Biologic Agents in Spinal Fusion Surgery

What is the role of biologic agents in spinal fusion surgery?

wound care

What is spinal fusion?

Spinal fusion is the most widely performed procedure in spine surgery. In spinal fusion surgeries, metal is commonly used to provide stabilization. However, metal does not have any cellular stimulating properties to produce bone, so the use of a biologic material or agent is often incorporated during the surgical procedure. The addition of a biologic material is to attract and stimulate cells to produce bone and promote fusion. Biologics may be used in conjunction with the patient’s own bone (autograft) or with donated bone (allograft).

Why would a surgeon choose a biologic agent?

Biologics and graft technology continues to evolve giving the surgeon a number of options that best meets the needs of the individual patient. The option of an allograft and biologic is often done to avoid complications that may occur at the donor site with autografts. There is evidence that using biologic agents in conjunction with grafts may improve the successful fusion outcome in many patients. 

What are some biologics used in spinal surgery?

wound care

An example of a common biologic used in spinal surgery are proteins used to stimulate bone growth and spinal fusion known as bone morphogenetic proteins, or “BMP’s”. Using BMP’s have been reported to reduce the pain and side effects that may be associated when harvesting the patient’s own bone.

Another biologic product that can be used is stem cells from the patient’s own bone marrow. Bone marrow cells are removed from the patient and by concentrating these cells and placing them on donors’ bone (allograft), this can replace the patient’s own bone in trying to achieve spinal fusion.

Synthetic biologics products are also available and are generally composed of ceramic or bioactive glass. Synthetic biologics may also be used in combination with an autograft as a bone graft extender, and research suggests that synthetic and biologic composites could potentially yield adequate bone healing without the need for autograft or high-dose growth factors.An example of a common biologic used in spinal surgery are proteins used to stimulate bone growth and spinal fusion known as bone morphogenetic proteins, or “BMP’s”. Using BMP’s have been reported to reduce the pain and side effects that may be associated when harvesting the patient’s own bone. 

What is the future of biologics ?

The future of biologics in spinal fusion surgery continues to evolve.  The use of gene therapy techniques, both to assist in spinal fusion and also potentially to repair damaged discs, thus avoiding performing a fusion and thereby the loss of motion is an example. Research and ongoing scientific understanding of the biological process involved in spinal disease are ongoing as are the development of new applications for treatment.

For a list of products that could accompany a surgical procedure, please visit https://sanaramedtech.com/surgical/

References

D’Souza, M., Macdonald, N. A., Gendreau, J. L., Duddleston, P. J., Feng, A. Y., & Ho, A. L. (2019). Graft Materials and Biologics for Spinal Interbody Fusion. Biomedicines, 7(4), 75. https://doi.org/10.3390/biomedicines7040075

Important Notice: The contents of the website such as text, graphics, images, and other materials contained on the website ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The content is not intended to substitute manufacturer instructions. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product usage. Please refer to our Terms of Use.

Susan has 30+ years of clinical experience across the continuum of care. Her experience includes direct patient care in critical care and wound care. She has demonstrated clinical and sales leadership roles with wound management organizations such as Healogics, and industry experience with companies such as HealthPoint. Her broad experience from bedside to innovation and industry has provided a unique perspective that she has shared as a consultant and educator. She has been actively involved with the Wound, Ostomy, Continence Society and has many years of service on the board of directors for the Association for the Advancement of Wound Care, and the American Board of Wound Management of which she also served as President. She is currently vice-chair for the American Board of Wound Management Foundation.