title: Stabilizing Effects of a Particulate Demineralized Bone Matrix in the L4 Interbody Space with and without PEEK Cage - A Literature Review and Preliminary Results of a Cadaveric Biomechanical Study.
abstract: We reviewed the biological elements supporting the usefulness of a specifically designed particulate form of demineralized bone matrix (DBM) with spinal fusion, and report some limitations of its use described in the medical literature and in the interbody space using a cadaveric biomechanical model. A literature review and description of the techniques used to augment spinal fusion are presented, including a more thorough review of recent findings of cadaveric biomechanical flexibility studies using DBM alone at different percentage fills of the existing disc space and DBM with a polyetheretherketone (PEEK) interbody cage. The need for DBM was established by reviewing limitations of autografts and allografts in spinal fusion. Demineralized bone matrix used alone did not increase stability post discectomy at L4-L5, but was demonstrated to exhibit satisfactory stability when used with a PEEK interbody cage. There may be a future role for DBM that hardens and fills disc space more rigidly, overcoming this limitation to its use.
authors.affiliation: Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica.
authors.forename: C
authors.initials: C
authors.lastname: Bruce
authors.affiliation: Charles E Schmidt College of Medicine at Florida Atlantic University and the Less Exposure Surgeons Surgery Institute (LESS Institute), Fort Lauderdale, FL, USA. kingsleychin@gmail.com.
authors.forename: K R
authors.initials: KR
authors.lastname: Chin
authors.affiliation: Less Exposure Surgery Society, Fort Lauderdale, FL, USA.
authors.forename: V
authors.initials: V
authors.lastname: Cumming
authors.affiliation: Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
authors.forename: N R
authors.initials: NR
authors.lastname: Crawford