Abjornson Celeste, Brecevich Antonio, Callanan Tucker, Dowe Christina, Cammisa Frank P, Lorio Morgan P
Hospital for Special Surgery, New York, New York.
Hughston Clinic Orthopaedics, Nashville, Tennessee.
Int J Spine Surg. 2018 Dec 21;12(6):757-771. doi: 10.14444/5095. eCollection 2018 Dec.
Autologous bone graft remains the gold standard by which bone graft substitutes are compared in spine fusion surgery. The utilization of bone graft substitutes, either as (1) an extender for spinal fusion constructs or (2) an alternative to minimize morbidity while maximizing outcomes, is changing. Moreover, current procedures technology (CPT) code 20939 became effective in 2018 defining bone marrow aspirate for bone grafting, spine surgery only. Changes in the complex landscape of grafting materials have prompted ISASS to provide category guidance for bone graft substitutes by comparing and contrasting US regulatory pathways, mechanisms of action, and supportive clinical evidence for these bone grafting materials.
自体骨移植仍是脊柱融合手术中用于比较骨移植替代物的金标准。骨移植替代物的用途正在发生变化，既可以（1）作为脊柱融合结构的扩展材料，也可以（2）作为一种替代物，在将发病率降至最低的同时使手术效果最大化。此外，现行手术技术（CPT）代码20939于2018年生效，仅适用于脊柱手术中用于骨移植的骨髓抽吸物。移植材料复杂情况的变化促使国际脊柱内固定研究学会（ISASS）通过比较和对比这些骨移植材料在美国的监管途径、作用机制和支持性临床证据，为骨移植替代物提供分类指导。
