Several years ago, I had a spinal fracture that was treated with something like super glue. Now I need a spinal fusion. The surgeon explained how they will use bone graft from my hip to fuse the two bones together. There may be some problems at the donor site. Why can’t they use the same cement to fuse the spine that they used to fix the fracture?

It sounds like you may have had a vertebroplasty procedure for a vertebral compression fracture (VCF). The surgeon injects a liquid cement that fills in the cracks of the fracture and hardens in place.

Spinal fusion, on the other hand, uses bone chips usually harvested from the iliac crest of the pelvis (or donated from a bone bank). To be a successful treatment, a bridge of bone must form between the two bones being fused together.

The harvested bone is no longer alive when it is placed around the area to be fused. But it provides a scaffold or framework for the body to fill in with new bone. And it stimulates new bone growth. The liquid cement used to fill fractures isn’t osteoinductive. This means it doesn’t have the ability to produce or stimulate bone growth needed.

There is a new option for bone graft called bone substitute. There are two bone substitute products on the market for use with humans. This implantable putty-like substance has the ability to induce bone growth in the area where it is placed.

Studies of its safety and efficacy are on-going. The protocol requires the patient to wear a rigid body brace for the first three months. A supervised physical therapy program is started about six weeks after the surgery.