Focus of the Report: This report evaluates the use of autologous concentrated bone marrow aspirate (CBMA) for spinal fusion surgeries.
Technology Description: Autologous CBMA may be implanted during spinal fusion procedures alone or as an adjunct to other bone grafting materials. CBMA is obtained by concentrating native bone marrow aspirate, which is usually obtained from the patient’s iliac crest prior to spinal surgery. CBMA contains mononuclear cells such as mesenchymal stem cells that can differentiate into a variety of cell types, including osteoblasts. While the mechanism of action for CBMA is not fully understood, it is thought to provide a direct cell source for promotion of bone healing.
Controversy: It is unclear whether the use of CBMA improves spinal fusion, and there is a lack of a consensus on the optimal enrichment protocol, delivery method, and progenitor cell dosing of CBMA preparations.
Key Questions:
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Is CBMA effective in promoting fusion and improving pain and function in patients undergoing spinal fusion procedures?
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How does CBMA compare with alternative therapies used as part of spinal fusion procedures?
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Is CBMA safe?
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Have specific patient selection criteria been identified for the use of CBMA in spinal fusion procedures?