Allograft: Cadaver Bone from a Tissue Bank

Allograft is bone harvested by a tissue bank from a cadaver for use in medical procedures. It can be prepared in a number of different forms (such as chips) for use in a spine fusion.

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Because allograft bone only provides a calcium scaffolding and does not have any bone-growing cells or bone-growing proteins required to stimulate new bone growth, it is not as successful in achieving a fusion as using the patient’s own bone.

Allograft bone may be used either on its own or as a supplement to the patient’s own bone.

• Allograft used on its own. In the lumbar spine, allograft bone is restricted for use in ALIF or PLIF procedures in which bone graft is placed in compression between the vertebrae, as the compression fosters a better healing process for the bone. In a posterolateral gutter spine fusion, in which the bone is placed in tension, allograft bone by itself is not likely to result in a solid fusion.
• Allograft as a supplement to the patient’s own bone. Allograft chips may be used to augment the patient’s own bone in a posterolateral gutter fusion.  It also may be used if more bone graft is needed in more extensive fusion procedures, such as fusion for adolescent scoliosis.

The main benefit of allograft bone is that there are no surgical risks for the patient associated with harvesting their own bone.  However, there are two main drawbacks.

• Lower chance of fusion. Because allograft bone does not contain living bone cells, it is not as effective at stimulating fusion as the patient’s own bone.
• Risk of disease transmission. Despite rules and regulations for tissue banks regarding processing and procedures of human tissue, there is still a small potential risk of disease transmission from using cadaver bone.

The allograft bone used in spine fusion procedures is provided by tissue banks (bone banks). The US Food and Drug Administration regulates US tissue banks in an effort to minimize risk of tissue contamination and disease transmission.

One common form of allograft that is used is Demineralized bone matrix (DBM)

• Article written By:
• Peter F. Ullrich, Jr., MD

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