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Osteobiologics

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Lateral Access Minimally Invasive Spine Surgery

Abstract

With the lateral approach, the surgeon is able to achieve a comprehensive discectomy with indirect decompression of the neural elements after placement of a large interbody graft. A number of bone grafts for interbody fusion can be used with this procedure, including iliac autograft, structural allograft and non-biological structural composite materials. The ideal graft for spine fusions should be osteoconductive, osteoinductive, and osteogenic. The iliac crest graft is the only scaffold that satisfies all three characteristics and has no donor rejection complications However, its harvest carries potential postoperative complications, and the amount of harvested material is often insufficient. There are several alternatives including demineralized bone matrix (DBM), bone morphogenetic proteins (BMP), and bone marrow aspirates. DBM scaffolds are osteoconductive and to some extent osteoinductive, whereas BMP and bone marrow aspirates (BMA) are osteoinductive and osteogenic. Even though DBM can be obtained in large amounts and there are no harvest morbidities, cell absence and donor variability are one of the main disadvantages. When choosing the right graft, the surgeon must consider patient’s age, disease condition, graft dose, and the surgical location.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 2011 Zonal Ave, HMR 710, Los Angeles, CA, 90033, USA

    Zorica Buser PhD

  2. McBride Orthopedic Hospital and Clinic, 9600 Broadway Ext, Oklahoma City, OK, 73114, USA

    Lance Smith

  3. University of Southern California, Los Angeles, USA

    Jeffrey C. Wang

Authors
  1. Zorica Buser PhD
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  2. Lance Smith
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  3. Jeffrey C. Wang
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Corresponding author

Correspondence to Zorica Buser PhD .

Editor information

Editors and Affiliations

  1. University of Miami Neurological Surgery, Miami, Florida, USA

    Michael Y. Wang

  2. Spine Surgery, Weill Cornell Medical Center Hospital for Special Surgery, New York, New York, USA

    Andrew A. Sama

  3. Dept. of Neurosurgery, University of South Florida Tampa General Hospital, Tampa, Florida, USA

    Juan S. Uribe

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© 2017 Springer International Publishing Switzerland

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Buser, Z., Smith, L., Wang, J.C. (2017). Osteobiologics. In: Wang, M., Sama, A., Uribe, J. (eds) Lateral Access Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-28320-3_29

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  • DOI: https://doi.org/10.1007/978-3-319-28320-3_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28318-0

  • Online ISBN: 978-3-319-28320-3

  • eBook Packages: MedicineMedicine (R0)

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