Bone Marrow Aspirate in Spine Surgery: Case Series and Review of the Literature

Abstract

BackgroundWith the modernization of biotechnology, there has been a concerted effort to create novel biomaterials to promote arthrodesis for spine surgery. The novel use of the stem cells from bone marrow aspirate (BMA) to augment spine surgery is a burgeoning field because these cells are considered to be both osteoinductive and osteogenic. We sought to review the evidence behind the use of BMAs in spinal fusions and report the results of our own case series. MethodsPubMed and EMBASE databases were searched for studies that investigated the use of stem cells for spine surgery. For our own case series, the medical records of 150 consecutive patients who underwent a lumbar spinal fusion with BMA were retrospectively reviewed for adverse events (AEs) for up to two years after surgery. ResultsIn our case series, there were no AEs identified in 49% of our patients. Of the identified AEs, 61% were unrelated to the use of BMA (e.g., UTI and heart failure), with the remaining 39% likely unrelated to its use (e.g., back pain and anemia). There was a 92.8% arthrodesis rate with the use of BMA. ConclusionsWe reviewed the rationale, basic science, and clinical science for BMA usage in spine surgery and concluded that BMA is safe for use in spine surgery and is associated with a high rate of arthrodesis.

Clinical and Radiographic Outcomes of Anterior Lumbar Interbody Fusions Using a Titanium Cage with a Biomimetic Surface

“…44 BMA has been used to overcome the drawbacks of relying solely on synthetic material to promote fusion. 46 This is particularly important since synthetic materials depend on the patient's own cells to stimulate or grow new osteocytes and can be affected by the multiple comorbidities of patients. 46 The active components of BMA are mesenchymal stem cells, creating a regenerative environment.…”

“…46 This is particularly important since synthetic materials depend on the patient's own cells to stimulate or grow new osteocytes and can be affected by the multiple comorbidities of patients. 46 The active components of BMA are mesenchymal stem cells, creating a regenerative environment. 46 A retrospective analysis of the International Spine Study Group reported a fusion rate of 87% after multilevel ALIF at 1 year based on computed tomography (CT) grading when using mineralized collagen and BMA, 47 which is lower compared with the fusion rates of 95% or more reported in the existing literature with BMP.…”

“…46 The active components of BMA are mesenchymal stem cells, creating a regenerative environment. 46 A retrospective analysis of the International Spine Study Group reported a fusion rate of 87% after multilevel ALIF at 1 year based on computed tomography (CT) grading when using mineralized collagen and BMA, 47 which is lower compared with the fusion rates of 95% or more reported in the existing literature with BMP. 48 Our findings suggest that achieving fusion rates comparable to those reported in the literature for BMP is possible by employing a titanium cage with a biomimetic surface and utilizing BMA in conjunction with other adjuncts such as Fibergraft and OsteoAMP.…”

Sacral Bioneuromodulation: The Role of Bone Marrow Aspirate in Spinal Cord Injuries

“…Additionally, the high cost and limited accessibility of advanced mechanical aids underscore the need for more broadly accessible and biologically focused therapies. BMA addresses these critical gaps by leveraging its regenerative potential to not only modulate inflammatory responses but also promote the regeneration of neural tissues and support functional recovery at a molecular level [16,[78][79][80]. Unlike traditional therapies, which are mostly palliative and adaptive, BMA offers a therapeutic strategy aimed at the root causes of neurodegeneration observed in SCI, providing a foundation for more definitive and sustainable recovery outcomes.…”

Combined effect of DBM, PRP, and bone marrow fluid on bone union in a rat posterolateral fusion model

“…This highlights the enhanced potential of PRP in facilitating the differentiation of osteoblasts and other bone-forming cells. These material advantages also include avoiding the risk of infection and fractures 12 , 13 . However, there have been only a few reports on the effects of these combinations on bone union.…”