Frequently Asked Questions

1. What are the key differences between the Graftech^® Cervical Dowel and traditional Cloward dowel grafts?



• The Graftech^® Cervical Dowel is a threaded allograft, resulting in 99% increase in resistance to graft expulsion forces than smooth Cloward dowels.
  
  
• The Graftech^® Cervical Dowel instrument system allows a smooth insertion with an intimate graft-to-patient bone fit without the impaction required to insert traditional Cloward dowels.
  
  
• The Graftech^® Cervical Dowel is inspected to ensure consistent dense cancellous bone quality and precise graft dimensions.
  
  
  
2. What are the key differences / similarities between the Graftech^® Cervical Dowel and the new metal cervical cages?



DIFFERENCES:


• The Graftech^® Cervical Dowel is an allograft that incorporates and remodels with patient bone over time.
  
  
• Allograft is osteoconductive, providing a scaffold to aid bony fusion.
  
  
• Allograft allows clearer post-operative imaging and fusion assessment.
  
  
• The Graftech^® Cervical Dowel provides greater graft contact area than cage fenestrations, leading to more robust fusions.
  
  
• Allograft has a proven history of success in the cervical spine.
  
  

SIMILARITIES:

• Both the Graftech^® Cervical Dowel and cervical cages are threaded to provide stability.
  
  
• Both the Graftech^® Cervical Dowel and cervical cages reduce the need to harvest autograft bone.
  
  
• Both the Graftech^® Cervical Dowel and cervical cages allow "no-profile" placement.
  
  
  
3. Is it possible to use powered instruments in preparation for the Graftech^® Cervical Dowel?

Some surgeons use powered instruments with hole-cutter bits to prepare for Cloward type dowels. This is also possible with the Graftech^® Cervical Dowel with the following changes to the standard Surgical Technique:

• The Guide Sleeves are not used.
  
  
• The hole-cutter diameter must be less than the reamer diameter described in Step D of the standard Surgical Technique.
  
  
• After preparing a hole with the powered instrument, use the appropriate Graftech^® Cervical Dowel reamer to ensure an accurate hole diameter.
  
  
• Gently thread the prepared hole with the appropriate Graftech^® Cervical Dowel Tap. Be sure to keep the instrument in-line with the hole during tapping.
  
  
• Insert the Graftech^® Cervical Dowel as described in the standard Surgical Technique.
  
  
  
4. Can Grafton^® DBM be used with the Graftech^® Cervical Dowel? How?




Yes. The proven osteoinductivity of Grafton^® DBM assists in promotion of the fusion. While many forms of Grafton may be used, Grafton^® DBM Gel is preferred since it is easily applied into the porous surface of the Graftech^® Cervical Dowel.