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Spinecare Topics
Options for Spine Treatments
Advancements in Spine Care and Spine Surgery
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Advancements in Spine Care and Spine Surgery
Ceramic and Carbon Fiber
Materials such as ceramic and carbon fibers have been used to carry bone and to replace part of the spine such as the vertebral body. One of the benefits of using carbon fiber is that it is radiolucent; therefore it does not interfere with X-ray imaging. It has a radiolucent quality that allows for better visualization of the actual bone graft to see if the bone graft is viable.
Bone Grafts
A common material used to provide stability and to fuse a spinal segment during spine surgery is bone. Bone may be acquired (harvested) from the patient’s own body (autologous bone) or may be obtained from a bone bank (allograft). Bone harvesting from a patient can result in acute and/or chronic pain at the donor site and in rare cases may result in a bone infection referred to osteomyelitis.
Plastics and Polymers
The rush is on to develop unique polymers that can be used to hold bone graft materials and also serve as a tissue spacer. Plastics and various polymers may be used because like carbon fibers they are radiolucent while providing strength and support. Polymers such as porous polyactic acid (PLA) are being developed which biodegrade over time. The material must remain long enough to provide support during the bony fusion process. Polymers can help provide needed flexibility at graft sites. Other biomaterials include calcium phosphates. Researchers are striving to identify the best materials that can be used to fill bone defects, such as when a fracture doesn't heal properly and to replace bone lost to tumor surgery or trauma.
Load Sharing Spinal Implants and Instrumentation
Spine implants are used to facilitate fusion, correct deformities, as well as to stabilize and strengthen the spine. Conditions that often require surgical placement of implants/instrumentation include instability (to much movement) of a spinal segment such as that seen with spondylolisthesis, chronic degenerative disc disease, traumatic fracture, and other forms of spinal instability including scoliosis. The types of spinal implants can be summarized as follows: rods, pedicle screws, hooks, plates and cages. Most spinal implants are made of metals such as titanium, titanium-alloy or stainless steel although some are made of non-metallic compounds. Some manufacturers emphasize the "the load sharing philosophy," of their spinal implants. Load sharing implies that the implant is designed in a way that weight bearing stresses are not focused onto a vulnerable area of the vertebrae but are dispersed over the front and posterior part of the vertebrae for the purpose of protecting spinal tissue and reducing the risk for pain. The load sharing should be as close to the pattern of load dispersal on a normal vertebral segment.
Disc Replacement/Artificial Disc
The future of spine surgery will include disc tissue replacement. As more minimally invasive surgical procedures are performed the spine surgeon will attempt to restore or maintain some flexibility of the spinal segment. An approach, which has begun to receive considerable attention, is the “artificial disc.� In contrast to current spine fusion techniques, Total disc replacement (TDR) is intended to serve as a dynamic spacer and to maintain some motion at the level of the operation once the damaged disc has been removed. In theory, TDR should help reduce mechanical stress upon adjacent discs by sharing the stress during spine movement and spine loading.
Materials such as ceramic and carbon fibers have been used to carry bone and to replace part of the spine such as the vertebral body. One of the benefits of using carbon fiber is that it is radiolucent; therefore it does not interfere with X-ray imaging. It has a radiolucent quality that allows for better visualization of the actual bone graft to see if the bone graft is viable.
Bone Grafts
A common material used to provide stability and to fuse a spinal segment during spine surgery is bone. Bone may be acquired (harvested) from the patient’s own body (autologous bone) or may be obtained from a bone bank (allograft). Bone harvesting from a patient can result in acute and/or chronic pain at the donor site and in rare cases may result in a bone infection referred to osteomyelitis.
Plastics and Polymers
The rush is on to develop unique polymers that can be used to hold bone graft materials and also serve as a tissue spacer. Plastics and various polymers may be used because like carbon fibers they are radiolucent while providing strength and support. Polymers such as porous polyactic acid (PLA) are being developed which biodegrade over time. The material must remain long enough to provide support during the bony fusion process. Polymers can help provide needed flexibility at graft sites. Other biomaterials include calcium phosphates. Researchers are striving to identify the best materials that can be used to fill bone defects, such as when a fracture doesn't heal properly and to replace bone lost to tumor surgery or trauma.
Load Sharing Spinal Implants and Instrumentation
Spine implants are used to facilitate fusion, correct deformities, as well as to stabilize and strengthen the spine. Conditions that often require surgical placement of implants/instrumentation include instability (to much movement) of a spinal segment such as that seen with spondylolisthesis, chronic degenerative disc disease, traumatic fracture, and other forms of spinal instability including scoliosis. The types of spinal implants can be summarized as follows: rods, pedicle screws, hooks, plates and cages. Most spinal implants are made of metals such as titanium, titanium-alloy or stainless steel although some are made of non-metallic compounds. Some manufacturers emphasize the "the load sharing philosophy," of their spinal implants. Load sharing implies that the implant is designed in a way that weight bearing stresses are not focused onto a vulnerable area of the vertebrae but are dispersed over the front and posterior part of the vertebrae for the purpose of protecting spinal tissue and reducing the risk for pain. The load sharing should be as close to the pattern of load dispersal on a normal vertebral segment.
Disc Replacement/Artificial Disc
The future of spine surgery will include disc tissue replacement. As more minimally invasive surgical procedures are performed the spine surgeon will attempt to restore or maintain some flexibility of the spinal segment. An approach, which has begun to receive considerable attention, is the “artificial disc.� In contrast to current spine fusion techniques, Total disc replacement (TDR) is intended to serve as a dynamic spacer and to maintain some motion at the level of the operation once the damaged disc has been removed. In theory, TDR should help reduce mechanical stress upon adjacent discs by sharing the stress during spine movement and spine loading.
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