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Related Concept Videos

The Bone Matrix01:18

The Bone Matrix

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Bone contains a relatively small number of cells entrenched in a matrix of collagen fibers that provide an adherent surface for inorganic salt crystals. Both components of the matrix, organic and inorganic, contribute to the unusual properties of bone. Without collagen, bones would be brittle and shatter easily. Without mineral crystals, bones would flex and provide little support. This can be observed by an experiment: when the minerals of a bone are dissolved by soaking the bone in...
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Cellular Bone Matrix in Spine Surgery - Are They Worth the Risk: A Systematic Review.

Mark J Lambrechts1, Tariq Z Issa1, Aditya Mazmudar1

  • 1Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

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|September 29, 2023
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Cellular bone matrix (CBM) shows high fusion rates in spine surgery but carries risks. More research is needed to confirm CBM benefits and safety in spinal fusion procedures.

Keywords:
cellular bone matrixcomplicationsosteobiologicspseudarthrosisspine fusion

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Spinal Fusion

Background:

  • Cellular bone matrix (CBM) is utilized as an osteobiologic in spinal fusion procedures.
  • The safety and efficacy of CBM in spine surgery require thorough evaluation.

Purpose of the Study:

  • To conduct a systematic review of the literature concerning complications and outcomes associated with CBM implantation during spine fusion.

Main Methods:

  • A systematic review of the PubMed database was performed from inception to January 31, 2023.
  • Studies reporting on specific CBM products in spinal fusion were analyzed for adverse events, reoperations, methods, and fusion rates.

Main Results:

  • Nineteen studies involving 7 CBM products were included. Fusion rates varied (lumbar: 68%-98.7%; cervical: 87%-100%), with inconsistent radiographic criteria.
  • While some studies reported no adverse events, one noted severe tuberculosis transmission. Conflicts of interest were present in 14 studies.

Conclusions:

  • Evidence for CBM in spine surgery is limited to low-grade, non-comparative studies, often industry-funded.
  • High fusion rates are reported, but severe complications, including infection, are a concern.
  • Further large-scale clinical trials are necessary to determine the risk-benefit profile of CBMs in spinal fusion.