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Minimally invasive bone harvesting tools.

T Steffen1, P Downer, B Steiner

  • 1Division of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada. tsteffen@orl.mcgill.ca

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|April 15, 2000
PubMed
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Spinal fusion bone grafting can be improved with regional vertebral or minimally invasive iliac crest harvesting. Both methods offer alternatives to traditional open surgery, with fillers restoring vertebral strength after regional graft removal.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Spinal Fusion Techniques

Background:

  • Autologous bone graft from the iliac crest is standard for spinal fusion but causes significant morbidity.
  • Open surgical harvesting of corticocancellous bone leads to increased patient complications.
  • Novel techniques aim to reduce morbidity associated with bone graft harvesting.

Purpose of the Study:

  • To evaluate regional vertebral bone harvesting and a minimally invasive iliac crest harvesting technique.
  • To assess the biomechanical impact of regional bone graft removal on lumbar vertebrae.
  • To investigate the efficacy of different bone graft substitutes in restoring vertebral strength.

Main Methods:

  • Regional bone grafts were harvested from lumbar vertebrae in a cadaveric model.

Related Experiment Videos

  • Vertebral defects were filled with tri-calcium phosphate, tantalum, or calcium phosphate cement.
  • A custom minimally invasive bone graft harvester was tested on cadaveric pelves.

    • Main Results:

    • Regional bone graft removal significantly reduced vertebral strength, but fillers restored it to intact levels.
    • Three different filler materials successfully restored mechanical strength.
    • The minimally invasive harvester yielded 10-20 cc of cancellous bone from the iliac crest.

    Conclusions:

    • Regional bone graft harvesting is anatomically safe and biomechanically acceptable for anterior spine surgery.
    • Various bone graft fillers can restore vertebral mechanical strength, though long-term behavior is unknown.
    • The minimally invasive harvester shows promise, but clinical data is pending.