Table 6

Published Fusion Rates for Bone Grafts.

AuthorEvaluation of FusionGraft MaterialComorbiditiesTimeFusion Rate
Dimar et al. (2006)32 CT: Solid Unilateral or bilateral fusionrhBMP-2/CRMWorkers comp – 13.2%
Spinal litigation- 3.8%
Smoking- 32.1%
12 months90.6%
ICBGWorkers comp -17.8%
Spinal litigation -15.6%
Smoking - 22.2%
12 months73.3%
Jenis and Banco (2010)37 CT: Graft consolidation on a least 2 contiguous cuts and in at least 2 of 3 planesSilicate-substituted calcium phosphate (Actifuse, Baxter)Smoking-9.5%
Diabetics- 9.5%
12 months76.2%
Nagineni etal. (2012)36 CT: Graft consolidation on a least 2 contiguous cuts and in at least 2 of 3 planesSilicate-substituted calcium phosphate (Actifuse, Baxter)Smoking – 11%∼12 months80% (Lumbaronly)
Nandyala etal. (2014)38 CT: Presence of bridging trabecular bone on at least 2 consecutive coronal and sagittal images, blurring of the bone-graft endplate junction, and absence of radiologic cleft within fusion massA Silicate-substituted calcium phosphate (Actifuse, Baxter)Workers comp –38.5%
Smoking – 30.8%
12 months65.4%
rhBMP-2 (INFUSE, Medtronic, Inc.)Workers comp –26.9%
Smoking – 26.9%
12 months92.3%
Roh et al. (2013)39 Radiograph: Presence of bridging bone across endplates or from endplates to interspace disc plugsrhBMP-2 (INFUSE, Medtronic, Inc.)Not available12 months83.5%
Allogenic Morphogenic protein (OsteoAMP, Advanced Biologics)Not available12 months93.3%
Park et al (2013)33CT: Presence of bridging trabecular bone on at least 2 images and cortication of the peripheral edges of the fusion massrhBMP-2 (INFUSE, Medtronic) with LBGNot available12 months85.7%
rhBMP-2 (INFUSE, Medtronic) with ICBGNot available12 months83.4%
Malham, etal. (2014)26 CT: Presence of bridging trabecular bonerhBMP-2 (INFUSE, Medtronic, Inc.)Smoking-9.2%
Diabetes-2.3%
Hypertension-7.6%
Depression-3.8%
Prior lumbar surgery-14.5%
12 months96.5% ALIF
97.8 Hybrid
Ammerman,et al. (2013)17 If patient asymptomatic: Radiographic evidence of bridging bone with no motion – 100% of patients evaluated with radiograph
or
If patient symptomatic: CT evidence of bridging bone
Allograft cellular bone matrix containing mesenchymal stem cells (MSCs) and osteoprogenitor cells combined with DBM and cancellous bone (Osteocel Plus, Nuvasive)Osteoporosis - 4.3%
Diabetes - 13.0%
Smoking - 4.3%
Chronic steroid use -4.3%
12 months92.3%
Tohmeh et al. (2012)40 Fluoroscopy-guided radiography (FGX)- 98% of patients evaluated with FGX
or
CT: Complete ossification with some component of endplate involvement. – One patient (3%) was evaluated with CT
Allograft cellular bone matrix containing mesenchymal stem cells (MSCs) and osteoprogenitor cells combined with DBM and cancellous bone (Osteocel Plus, Nuvasive)Tobacco use - 12.5%
Coronary ArteryDisease - 47.5%
Diabetes - 20%
COPD - 5%
Steroid use - 8% Any prior spinesurgery - 65% Any prior spinesurgery - 65%
12 months90.20%
Sardar, etal. (2015)19 Based on Medical Metrics Inc. (Houston, Texas) criteria using CT and radiographs:
Evidence of bridging bone
Less than 50% radiolucency
Less than 5 degrees of motion and less than 3 mm translation
B2A peptide (Prefix 150, BioSET, Inc)Not available12 months50%
B2A peptide (Prefix 750, BioSET, Inc)Not available12 months100%
ICBGNot available12 months77.80%
Lauweryns,et al. (2015)34 CT: Presence of bridging trabecular boneABM/P-15 (i-FACTOR, Cerpedics, Inc.)*BMI 25-30 - 40%
BMI >30 - 20%
Tobacco use - 27.5%
Diabetes - 12.5%
12 months97.78%
ABG12 months82.22%
Thaler et al. (2013)41 Radiograph: Bony bridging, bony continuity between endplate, trabecular structure in anterior bone and lack of radiolucent lines
CT: 30% of endplate to endplate bridging anteriorly. Continuous intersegmental bridging in posterior column.
β – TCP (Chronos, Synthes)Smoking – 32.4% Previous lumbar surgery adjacent to index level – 23.5%12 monthsRadiographic– 47.7%
CT – 61.4%
Berjano,etal. (2015)35 CT: Evidence of bridging trabecular bone from lower endplate to upper endplateSynthetic bone graft comprised of calcium phosphate granules and hydroxyapatite (Attrax,Nuvasive)Not available12 months83%
Nanocrystals -nanohydroxyapatite-based bone graft substitute (Nanostim, Medtronic)Not available12 months100%
ABGNot available12 months75%
Calcium triphosphateNot available12 months89%
Kurd et al. (2014)18CT: Brantigan, Steffee, Fraser method42
Radiographs: < 5 degrees motion
Osteconductive - allografts, tri-calcium phosphate (Vitoss, Orthovita, Inc), silicate-substitutedcalcium phosphate (Actifuse, ApaTech), ceramics (Mastergraft, Medtronic), andhydroxyapatite products (nannOss, Pioneer)BMI (mean, SD) -32.5, 7.1
Smoking - 39.2%
12 months93.75%
Osteoinductive - rhBMP-2 (Infuse Kit, Medtronic), demineralized bone matrices (GraftonDBM Matrix, Medtronic, Progenix DBM Putty, Medtronic), and stem cell-based products (Osteocel Plus, Nuvasive Inc)BMI (mean, SD): 30.6,6.4
Smoking (%): 36.1%
12 months87.18%
  • * Not available for sale in the USA.