Procedures in San Francisco CA
Bone graft is the material that is used to promote fusion or adjoining several vertebrae together. It can come from the patient himself (autograft) from another human (allograft) or another species, such as coral (xenograft). Also, a bone graft extender can be utilized, in which case it does not come from any living organism and is purely synthetic. Occasionally we utilize synthetic protein for a bone graft, which is a growth factor called bone morphogenetic protein (BMP-2 or INFUSE). It is a growth factor that promotes bone formation and has been successfully used in clinical application anywhere from skull to spine and extremities in the past decade or so.
Depending on the procedure, the patient’s preferences, as well as the patient’s medical history (such as smoking, diabetes, and history of prior surgeries), the surgeon may choose one or more from the bone graft options above.
Another option for a bone graft involves drawing bone marrow from the iliac crest or vertebrae and hyperconcentrating it to yield concentrate of the stem cells. Derived from the patient himself, the stem cells are known as pluripotent, meaning that they are able to mature into multiple types of tissue. In the case of spine surgery, the goal is to promote maturation of the stem cells into bone-forming cells (osteocytes and osteoblasts). We have successfully utilized a bone marrow aspirate concentrate system (BMAC from Harvest) at St. Mary’s Spine Center for more than a year, with excellent clinical results. The main advantage of bone marrow aspirate concentrate is decreased morbidity of the bone graft harvest.