Bone Fiber Bullets Provide Improved Allograft Delivery

By HospiMedica International staff writers
Posted on 28 Jan 2021
A demineralized bone fiber (DBF) bullet facilitates grafting during minimally invasive surgery (MIS) orthopedic applications.

The TheraCell (Los Angeles, CA, USA) TheraFuze DBF Fiber Bullets are made from cortical DBF using a proprietary process that produces uniform six mm bullets, while still preserving the natural collagen structure. The Fiber Bullets can be inserted into a bone void or cage through a cannulated delivery system so that they can hydrate on site; as they hydrate, they form an entangled mass that resists migration and enhances the ability to fill defects completely, such as in endplate to endplate contact, which is important to achieving fusion.

Image: Lyophilized Fiber Bullets delivered through a cannula (Photo courtesy of TheraCell)

The nanotopography of the DBF surface is designed to maintain the collagen structure of bone and to preserve its osteo-inductive proteins. This is achieved via patented processing technologies in which the mineral component of bone is removed prior to cleaving it along the axis of collagen orientation. The gentle process provides a nanotopographic structure unobtainable in conventional demineralized bone matrix products. The allograft also has an osteoinductive potential and enhanced handling properties that are ideal for spinal fusion and other orthopedic applications.

“I placed several Fiber Bullets in the lyophilized state anterior to the implant to fill the interbody space with graft material. Subsequent to the cage insertion, several additional Fiber Bullets were placed posterior to the cage to ensure complete endplate to endplate apposition,” said Neel Anand, MD, of Cedars Sinai Medical Center (Los Angeles, CA, USA), who used the bullets in an interbody TLIF cage procedure. “Delivery of the bullets through a cannula is a very convenient option. The entire procedure was quite simple and fit into my usual surgical process with ease.”

DBF is an autograft, allograft, or xenograft bone product prepared by removing inorganic minerals and leaving a matrix containing mainly collagen, and also allowing exposure of bone morphogenetic proteins (BMPs) that retain their biological activities.

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