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Open AccessReview

Graft Materials and Biologics for Spinal Interbody Fusion

1
School of Medicine, Mercer University School of Medicine, Macon, GA 31207, USA
2
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
*
Author to whom correspondence should be addressed.
Biomedicines 2019, 7(4), 75; https://doi.org/10.3390/biomedicines7040075
Received: 25 August 2019 / Revised: 19 September 2019 / Accepted: 24 September 2019 / Published: 26 September 2019
(This article belongs to the Section Neurologic Diseases)
Spinal fusion is the most widely performed procedure in spine surgery. It is the preferred treatment for a wide variety of pathologies including degenerative disc disease, spondylolisthesis, segmental instability, and deformity. Surgeons have the choice of fusing vertebrae by utilizing cages containing autografts, allografts, demineralized bone matrices (DBMs), or graft substitutes such as ceramic scaffolds. Autografts from the iliac spine are the most commonly used as they offer osteogenic, osteoinductive, and osteoconductive capabilities, all while avoiding immune system rejection. Allografts obtained from cadavers and living donors can also be advantageous as they lack the need for graft extraction from the patient. DBMs are acid-extracted organic allografts with osteoinductive properties. Ceramic grafts containing hydroxyapatite can be readily manufactured and are able to provide osteoinductive support while having a long shelf life. Further, bone-morphogenetic proteins (BMPs), mesenchymal stem cells (MSCs), synthetic peptides, and autologous growth factors are currently being optimized to assist in improving vertebral fusion. Genetic therapies utilizing viral transduction are also currently being devised. This review provides an overview of the advantages, disadvantages, and future directions of currently available graft materials. The current literature on growth factors, stem cells, and genetic therapy is also discussed. View Full-Text
Keywords: allograft; autograft; biologics; bone-morphogenetic protein; ceramic; demineralized bone matrix; spinal fusion; genetic therapy; graft; mesenchymal stem cells allograft; autograft; biologics; bone-morphogenetic protein; ceramic; demineralized bone matrix; spinal fusion; genetic therapy; graft; mesenchymal stem cells
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D’Souza, M.; Macdonald, N.A.; Gendreau, J.L.; Duddleston, P.J.; Feng, A.Y.; Ho, A.L. Graft Materials and Biologics for Spinal Interbody Fusion. Biomedicines 2019, 7, 75.

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