Optimal aspiration volume of vertebral bone marrow for use in spinal fusion

Abstract

Background context Bone marrow aspirate (BMA) has shown promise as a bone graft option in spinal fusion. The vertebral body is a convenient source for marrow aspirate as it is accessed in routine course of pedicle screw instrumentation. Studies have relied on data from the iliac crest to determine optimal aspiration volume from the vertebral body. Purpose This study is designed to determine the optimal aspiration volume for BMA taken from the vertebral body. Study design Prospective clinical study. Patient sample Data are drawn from 18 pedicles and 180 aspirations. The average age of the subjects was 50.3 years, and the subject pool comprised five men and seven women. Outcome measures Nucleated cell count and alkaline phosphatase staining colony forming units. Methods Ten 1 mL aliquots of BMA were incrementally aspirated through a cannulated pedicle tap for each instrumented vertebral body. The numbers of nucleated cells per mL of BMA were analyzed with a hemocytometer, and the percentage of osteoprogenitor cells per mL aspirate were estimated by an alk phos production assay. The study was funded through departmental funds, and none of the authors have any conflicts of interest to report related to the study. Results Nucleated cell count decreased with increasing aspirate number (p