I'm going to have a second back surgery next month. The first one was a spinal fusion at L45. Now I'm having a second fusion. But I'm considerably older now than when I had the first fusion done. My bones are more brittle so I'm not sure using the same kind of bone graft (from my hip) will work. Are there any other ways to do this?

For over 100 years, graft material has been taken from the patient's own pelvic/hip bone whenever possible. This is considered the gold standard in successful fusions.

An alternate choice is allograft material. This is bone taken from a cadaver (donor bone harvested after death). It is specially treated and frozen until ready to be used.

More recently, scientists have discovered proteins that are osteoinductive. This means the graft material can form new bone in a non-bony area. These proteins are called bone morphogenetic protein (BMPs).

There are at least 14 BMPs that belong to a group of proteins called growth factor-ß. Two BMPs are now available for patient use. These are recombinant BMPs meaning they have been developed for use in a lab.

Mention your concerns and questions to your surgeon. He or she has access to your imaging studies and knows the condition of your bones and your general health. There are many factors that go into deciding the best way to perform a spinal fusion, including the surgeon's own expertise and preferred methods.