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COMMENTARY
Year : 2022  |  Volume : 9  |  Issue : 2  |  Page : 110

Commentary on “Does harvesting cancellous bone destabilise cervical spine in cervical inter body fusion? A prospective clinico radiological analysis”


Department of Neurosurgery, Bombay Hospital; Department of Neurosurgery, Lilavati Hospital, Mumbai, Maharashtra, India

Date of Submission09-Apr-2022
Date of Acceptance19-Apr-2022
Date of Web Publication31-May-2022

Correspondence Address:
Atul Goel
Department of Neurosurgery, Bombay Hospital, Mumbai, Maharashtra; Department of Neurosurgery, Lilavati Hospital, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joss.joss_17_22

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How to cite this article:
Goel A. Commentary on “Does harvesting cancellous bone destabilise cervical spine in cervical inter body fusion? A prospective clinico radiological analysis”. J Spinal Surg 2022;9:110

How to cite this URL:
Goel A. Commentary on “Does harvesting cancellous bone destabilise cervical spine in cervical inter body fusion? A prospective clinico radiological analysis”. J Spinal Surg [serial online] 2022 [cited 2022 Jul 7];9:110. Available from: http://www.jossworld.org/text.asp?2022/9/2/110/346357












Dr. Parthiban introduces two novel techniques of harvesting bone graft in the more commonly performed surgical procedure of anterior cervical discectomy and fixation or the ACDF technique. Bone graft is harvested from the vertebral bodies adjacent to the treated spinal segments. In addition, bone pieces procured by sectioning of the osteophytes and scraping of the vertebral end plates are used as a grafting material. Tricalcium phosphate granules are used to pack into the titanium cage and stabilize the graft bone material.

The relative ease of harvesting of the bone graft from the adjacent vertebral bodies and use of otherwise discarded bone pieces available from resected osteophytes and endplate scraping are the highlights. Avoiding additional incisions is obviously an advantage. More importantly, the techniques adopted demonstrate the emphasis of the author in focusing to achieve arthrodesis of the treated spinal segments.

Although not evaluated at length, it does appear that the bone available locally, like in the presented techniques, is more compatible and “familiar” with the environment and has enhanced possibility of being accepted for arthrodesis. The high vascularity of the cancellous content of the vertebral body bone makes it an ideal grafting material. To take an additional incision to harvest, a relatively small quantity of bone that is necessary for the procedure can be avoided.

As the graft material is harvested from the center of the vertebral body, there appears to be little or no danger of vertebral body subsidence. Moreover, it appears that the region of vertebral body from where the graft is harvested will eventually reform or heal.

It is apparent that if the discussed technique is learned adequately and performed as described, it can become an integral step of the ACDF surgery.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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