Improving the clinical evidence of bone graft substitute technology in lumbar spine surgery

Wellington K Hsu, M S Nickoli, J C Wang, J R Lieberman, H S An, S T Yoon, J A Youssef, D S Brodke, C M McCullough, Wellington K Hsu, M S Nickoli, J C Wang, J R Lieberman, H S An, S T Yoon, J A Youssef, D S Brodke, C M McCullough

Abstract

Bone graft substitutes have been used routinely for spine fusion for decades, yet clinical evidence establishing comparative data remains sparse. With recent scrutiny paid to the outcomes, complications, and costs associated with osteobiologics, a need to improve available data guiding efficacious use exists. We review the currently available clinical literature, studying the outcomes of various biologics in posterolateral lumbar spine fusion, and establish the need for a multicenter, independent osteobiologics registry.

Keywords: autograft; biologics; bone graft substitute; bone morphogenetic protein; ceramics; demineralized bone matrix; osteobiologics; spine fusion.

Conflict of interest statement

Disclosures W. K. Hsu, Consulting: Stryker, Pioneer, Medtronic, Zimmer, Graftys; Research Support: Baxter, Pioneer M. S. Nickoli, None J. C. Wang, Royalties: Medtronics, Stryker, Seaspine, Osprey, Aesculap, Biomet, Amedica, Zimmer, Synthes; Stock Ownership: Fziomed; Private Investments: Promethean Spine, Paradigm Spine, Benevenue, NexGen, K2 Medical, Pioneer, Amedica, Vertiflex, Electrocore, Surgitech, Axiomed; Board of Directors: North American Spine Society, Cervical Spine Research Society, AO Spine/AO Foundation; Scientific Advisory Board: VG Innovations, Corespine, Expanding Orthopaedics, Syndicom, Osprey, Amedica, Bone Biologics, Curative Biosciences, PearlDiver, Inc., Pioneer, Seaspine J. R. Lieberman, Research Support: Amgen, Inc., NIH; Advisory Board, Amgen, Inc. H. S. An, Consulting: Advanced Biologics, Inc., Pioneer, Inc.; Research support: Baxter, Inc. S. T. Yoon, None J. A. Youssef, Consultant: NuVasive, Integra; Royalty: NuVasive, Aesculap/B. Braun, Osprey, Amedica; Research Support: DePuy, Stryker, NuVasive, BioSurface Engineering Technologies, Globus Medical, Advanced Technologies in Regenerative Medicine, Axial Biotech, Vertiflex; Stock Options: Amedica, Pioneer, Vertiflex, Benvenue Medical, Inc., Paradigm Spine, Promethean Surgical Devices, Spinal Ventures D. S. Brodke, None C. M. McCullough, None

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