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Cellular Bone Matrix in Spine Surgery – Are They Worth the Risk: A Systematic Review – Lumbar Fusion

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The article is a systematic review that aims to assess the complications and outcomes associated with cellular bone matrix (CBM) during spine fusion procedures. The researchers conducted a search on the PubMed database and identified 19 articles that reported on 7 different CBM products. The studies included evaluations of lumbar and cervical fusion, as well as adverse events related to CBM. The fusion rates varied but generally ranged from 68% to 98.7% in the lumbar spine and 87% to 100% in the cervical spine. However, there was no consensus on what constituted a complication, and one study even reported a severe case of disseminated tuberculosis from contaminated CBM. Additionally, 14 of the studies had conflicts of interest with the manufacturer or distributor of the analyzed CBM. Overall, the current evidence is limited to low-grade non-comparative studies funded by industry, and more large clinical trials are needed to determine the benefits and risks of CBMs in spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: Current evidence regarding the use of cellular bone matrix as an osteobiologic during spine surgery is weak and limited to low-grade non-comparative studies subject to industry funding. While reported fusion rates are high, the risk of severe complications should not be overlooked. Further large clinical trials are required to elucidate whether the CBMs offer any benefits that outweigh the risks.

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Global Spine J. 2023 Sep 29:21925682231205099. doi: 10.1177/21925682231205099. Online ahead of print.ABSTRACTSTUDY DESIGN: Systematic Review.OBJECTIVE: To review the literature for complications and outcomes after the implantation of cellular bone matrix (CBM) during spine fusion.METHODS: The PubMed database was queried from inception to January 31, 2023 for any articles that discussed the role of and identified,

Global Spine J. 2023 Sep 29:21925682231205099. doi: 10.1177/21925682231205099. Online ahead of print.

ABSTRACT

STUDY DESIGN: Systematic Review.

OBJECTIVE: To review the literature for complications and outcomes after the implantation of cellular bone matrix (CBM) during spine fusion.

METHODS: The PubMed database was queried from inception to January 31, 2023 for any articles that discussed the role of and identified a specific CBM in spinal fusion procedures. Adverse events, reoperations, methods, and fusion rates were collected from all studies and reported.

RESULTS: Six hundred articles were identified, of which 19 were included that reported outcomes of 7 different CBM products. Seven studies evaluated lumbar fusion, 11 evaluated cervical fusion, and 1 study reported adverse events of a single CBM product. Only 4 studies were comparative studies while others were limited to case series. Fusion rates ranged from 68% to 98.7% in the lumbar spine and 87% to 100% in the cervical spine, although criteria for radiographic fusion was variable. While 7 studies reported no adverse events, there was no strict consensus on what constituted a complication. One study reported catastrophic disseminated tuberculosis from donor contaminated CBM. The authors of 14 studies had conflicts of interest with either the manufacturer or distributor for their analyzed CBM.

S: Current evidence regarding the use of cellular bone matrix as an osteobiologic during spine surgery is weak and limited to low-grade non-comparative studies subject to industry funding. While reported fusion rates are high, the risk of severe complications should not be overlooked. Further large clinical trials are required to elucidate whether the CBMs offer any benefits that outweigh the risks.

PMID:37773001 | DOI:10.1177/21925682231205099

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Cellular Bone Matrix in Spine Surgery – Are They Worth the Risk: A Systematic Review

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Global Spine J. 2023 Sep 29:21925682231205099. doi: 10.1177/21925682231205099. Online ahead of print.ABSTRACTSTUDY DESIGN: Systematic Review.OBJECTIVE: To review the literature for complications and outcomes after the implantation of cellular bone matrix (CBM) during spine fusion.METHODS: The PubMed database was queried from inception to January 31, 2023 for any articles that discussed the role of and identified

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