Bone grafting and biologics for spinal fusion in the pediatric population: current understanding and future perspective

Document Type

Article

Abstract

Pediatric spinal fusions have been associated with nonunion rates of approximately 25%, putting patients at risk for neurological complications while simultaneously incurring significant costs for revision surgery. In an effort to decrease nonunion rates, various bone grafts and biologics have been developed to increase osseous formation and arthrosis. The current gold-standard bone graft is autologous bone taken from the iliac crest or ribs, but this procedure is associated with significant morbidity and postoperative pain due to an additional graft harvesting procedure. Other bone graft substitutes and biologics include allografts, demineralized bone matrix, bone morphogenetic protein, and bioactive glass. Ultimately, these substitutes have been studied more extensively in the adult population, and there is a paucity of strong evidence for the use of these agents within the pediatric population. In this review, the authors will discuss in detail the characteristics of the various bone graft substitutes, their fusion efficacy, and their safety profile in this subpopulation.

Medical Subject Headings

Adult; Biological Products (therapeutic use); Bone Substitutes (therapeutic use); Bone Transplantation; Child; Humans; Ilium; Spinal Diseases; Spinal Fusion

Publication Date

6-1-2021

Publication Title

Neurosurgical focus

E-ISSN

1092-0684

Volume

50

Issue

6

First Page

E8

PubMed ID

34062508

Digital Object Identifier (DOI)

10.3171/2021.3.FOCUS2148

Link to Full Text

Share

COinS