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Comparing Bone Substitute to the Real Thing for Neck Fusion

Many adults suffer pain and loss of stability in the neck (cervical spine). When surgery is needed for this problem, surgeons often recommend a procedure to fuse two or more neck vertebrae together. Fusion holds the bones in place and takes pressure off the nerves.

A spine fusion is held together with bone graft and metal plates. Pieces of bone may be shaved off the pelvis bone to form the bone graft. However, the spot on the pelvis where the bone was taken may develop problems such as pain, fracture, nerve damage, and infection. Doctors in this study tried to find an acceptable substitute for bone graft material.

Calcium carbonate can be taken from sea coral plants. Scientists are able to change this hard substance into a compound and use it as a bone substitute. The bone substitute is called ProOsteon 200. In this study, doctors compared fusion of the neck using patients' own bone versus fusion using the bone substitute.

They found that patients were equally satisfied in both groups. However, X-rays and CT scans showed that the ProOsteon didn't hold up. In fact, the study was ended early with no more patients allowed in the bone substitute group.

Authors of this study found that ProOsteon is a brittle material that has only 2.2 percent the strength of bone. Less than half the grafts took hold. One-third of the bones that were to be fused collapsed. They suggest that until better bone substitutes are found, bone taken from the patient's pelvic bone is preferred for cervical spine fusion.

References: Jeffrey R. McConnell, MD, et al. A Prospective Randomized Comparison of Coralline Hydroxyapatite With Autograft in Cervical Interbody Fusion. In Spine. February 15, 2003. Vol. 28. No. 4. Pp. 317-323.

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