How to pick a bone graft for multilevel spine fusion
What to ask your surgeon before a multilevel fusion in Cincinnati Children’s, OH.
Your next case is a 3-level spine fusion in a patient with risk factors. You practice in Cincinnati Children’s, OH, where you see everything from athletic injuries to complex deformities. The nonunion rate climbs with each added level, and you don’t want to rely on a graft with thin evidence. You want a choice backed by published data in multilevel fusions.
A multilevel fusion—two or more vertebrae—has a higher chance of not healing. The longer the fusion bed, the more bone graft material you need, and the more demand on the body’s healing response. If the graft doesn’t stimulate enough new bone, a nonunion can happen. That means more pain and possibly another surgery. Choosing the right graft substitute is a direct way to lower that risk.
The cost of a bone graft substitute varies. Autograft from the hip adds operative time and a second surgical site, with its own pain and complications. Allograft avoids that but lacks living cells. Synthetics like ACTIFUSE are priced between them, and they eliminate the harvest site. The real cost, though, is a failed fusion. A revision surgery costs tens of thousands of dollars and months of recovery. Investing in a graft with a 93% fusion rate in a large series can save that downstream cost.
This week, review the published data on your graft options. Look for studies that report fusion rates specifically in multilevel posterolateral fusions. Ask your rep for the Johns Hopkins independent review of ACTIFUSE—694 patients, 93% fusion, same as BMP-2 but with less back pain and no iliac crest harvest. Elite Surgical can bring that evidence to your office in Cincinnati Children’s and in-service your staff on the moldable form that covers long fusion beds evenly.
After you choose a graft with strong multilevel data, you go into the OR confident. The fusion heals solidly on the first try. Your patient avoids a revision, and you have a reliable option for the next tough case.
Other things people in Cincinnati Children’s ask
bone graft harvest site pain alternatives
Stop harvesting from the iliac crest. A synthetic bone graft substitute like ACTIFUSE removes the second surgical site entirely. No harvest means no donor site pain, no extra scar, and one less thing to manage post-op. The fusion rates are the same without the extra morbidity.
bone graft substitute for smokers spine fusion
Look for a synthetic graft with published fusion data in high-risk patients. ACTIFUSE has a 93% fusion rate in an independent spine study, comparable to BMP-2, without the need to harvest hip bone. Discuss smoking cessation, but choose a graft that has shown strong results even when patient compliance is imperfect.
cost of bone graft substitute per level spine fusion
Calculate the all-in cost: graft price, OR time for harvest, donor site pain management, and readmissions for nonunion. A synthetic graft like ACTIFUSE often costs more up front but eliminates harvest-related expenses. Ask your rep for a cost-per-fusion analysis that includes complication avoidance.
bone graft substitute migration spine fusion
Small amounts of graft migration outside the intended area are common and often do not harm the fusion. If the graft is far from the fusion site or compressing a nerve, revision may be needed. Check the CT carefully for any contact with neural structures. If there are no symptoms and the bulk of graft is in place, monitor the fusion progress on the next scan.
ACTIFUSE FLOW vs ACTIFUSE MIS
ACTIFUSE FLOW comes in a syringe for precise, low-pressure delivery into tight bony spaces. ACTIFUSE MIS is a purpose-built system for minimally invasive spine and orthopedic procedures, offering longer reach and controlled placement. If you are working through a small portal and need to fill a far corner, MIS gives you more control. For straightforward contained defects, FLOW is faster.
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Elite Surgical handles spine fusion in Cincinnati Children’s and the area around it.