Generally you think of a new robotic devices, high-tech surgical equipment or new imaging techniques when you think of advances in surgery. One of the advances that is just as futuristic, but a little more quietly so, is one of the new "biologics" for use in surgery like bone morphogenetic proteins (BMPs), which can provide all the benefits of self-donated bone without many of the disadvantages.
"BMP allows increased fusion rates and more rapid healing," according to Howard An, MD. The proteins in BMP are a basic part of the body's system for building new bone. Thanks to recent research these proteins can now be manufactured, providing a near perfect substance to enhance the body's bone repair and healing process.
Some types of bone grafting that are available include:
"Any patients undergoing spinal fusion are candidates for potential use of bone grafting technology and BMP," says An. "Patients should discuss with the spinal surgeon about the specific technique of fusion such as types of instrumentation, types of bone grafts, advantages, disadvantages, etc., so that any decision made is a well informed one."
- Self-donated or autogenous bone grafts: Bone is taken from another part of the body, which is beneficial because body probably won't "reject" the tissue (the immune system recognize the tissue as part of your body, so it does set up defenses against it). This does add another surgery, before the spine surgery to "harvest" the bone from another site in the body.
- Donor provided or allograft bone: Bone comes from a donor, which opens to possible problems with acceptance by the immune system. It has the benefit of avoiding extra surgery to harvest the bone as with self-donated bone grafts.
- Demineralized boned matrix (DBM): A product of processed bone from a donor. It contains collagen, proteins and growth factors extracted from the donated bone.
- Ceramics: Mineral-based substitute for bone, often used as a framework for bone growth, but doesn't contain the growth factors found in the products above.
- Biologics like BMPs: Provides all the benefits of self-donated bone with none of the disadvantages. It also provides some of the flexibility of use and deliver of the DBM and ceramics.
- Howard An, MD, and his colleagues will speak on innovations on spine, back and neck treatments on Wednesday, January 28, 2009, in Room 994 of the Armour Academic Building at Rush University Medical Center in Chicago.
More Information at Your Fingertips:
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