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Alternative Graft Site for Cervical Spine Fusion

Disc disease causing neck and arm pain may be treated with disc removal called a discectomy. Most often after the disc is taken out, the surgeon fills the gap with a mesh cage filled with bone graft. For the best results, the graft is taken from the patient's own bone. This is called an autograft.

The most common donor site is the pelvic bone. But painful symptoms after bone removal have led doctors to look for alternative donor sites. In this study, bone from the manubrium (the sternum or breast bone) was used with good results.

Ten patients were treated with anterior cervical discectomy and fusion (ACDF) at one level in the cervical spine (neck). A titanium, mesh cage, manubrium graft, and metal plate were used to fuse the spine.

Everyone had immediate relief of pain. X-rays at three months showed signs of a solid fusion. There were no complaints of donor site pain, a common problem with pelvic bone grafts. Only one patient was unhappy with how the scar looked.

This is the first report of manibrium autograft used in ACDF surgery. The authors conclude manibrium autografts are safe and effective. Fusion rates were very high when used in single-level fusions. Fututre studies are needed to test the use of this alternative bone graft site for fusion at multilevel (two or more) segments.

References: Michael W. Peelle, MD, et al. A Novel Source of Cancellous Autograft for ACDF Surgery: The Manubrium. In Journal of Spinal Disorders & Techniques. February 2007. Vol. 20. No. 1. Pp. 36-41.

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