What are the common sources for bone graft material used in spinal arthrodesis procedures

Graft options for spinal fusion include autograft, allograft, and synthetics. Sources for autograft bone include the patient's fibula, ribs, and ilium. Autograft may be procured as a structural or nonstructural graft. The ratio of cancellous to cortical bone varies depending on the bone graft site and technique of graft procurement. Allograft bone is human cadaveric bone that can be stored as either a fresh-frozen or freeze-dried preparation. It is available in a variety of shapes and composition similar to autograft bone. Allograft bone may also undergo processing by acid extraction to remove bone mineral while retaining collagen and noncollagenous proteins. The end product is demineralized bone matrix (DBM), an allograft form with osteoinductive activity. Additional graft materials available for use in fusion procedures include ceramics, polymers, composite materials, and bone morphogenetic proteins (BMPs). Bone marrow aspirate (BMA) may be combined with graft material to improve its osteogenic potential.

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