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JRPMS Vol 6, No 3, September 2022, p.93-97

doi: 10.22540/JRPMS-06-093


Mini Review

Biological action of calcium phosphate grafts on the spine

Aristeidis Papadogoulas1, Panagiotis Lepetsos2, Christos P. Zafeiris1

  1. Postgraduate Program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School, Athens, Greece
  2. Athens Medical Center, Athens, Greece

Keywords: Calcium phosphate, Grafts, Hydroxyapatite, Spinal fusion, Spine


Despite the evolution in the field of grafting alternatives for spinal surgery, autologous iliac crest bone graft remains the gold standard for spinal fusion. However, donor site morbidity and limited availability stress the need for reliable substitutes. Calcium phosphate grafts, such as hydroxyapatite (HA) and tricalcium phosphate β (TCP-β), are a promising group of bone grafts in spinal surgery. The advantages of these grafts in spinal surgery are large availability, relatively rigid structure, low immunogenicity and high biocompatibility. However, they contain no living cells, no growth factors, no organic matrix and they are characterized by limited cortical stability and lack of osteogenic properties. Most studies have noticed that calcium phosphate grafts are efficient alternatives of autografts with similar fusion rates and functional outcome, in spinal fusion surgery. However, most of these studies are of low quality, lacking proper control groups. More prospective, randomized trials are needed in order to fully elucidate the optimal use of calcium phosphate grafts in spinal surgery