Bone grafting.
In recent years our understanding of spinal fusion biology has improved. This includes the continued elucidation of the step-by-step cellular and molecular events involved in the prototypic bone induction cascade, as well as the identification and characterization of the various critical growth factors governing the process of bone formation and bone graft incorporation. Based on these fundamental principles, growth factor technology has been exploited in an attempt to improve rates of spinal fusion, and promising results have been realized in preclinical animal studies and initial clinical human studies. In this article the authors review the recent advances in the biology of bone fusion and provide a perspective on the future of spinal fusion, a future that will very likely include increased graft fusion rates and improved patient outcome as a result of the successful translation of fundamental bone fusion principles to the bedside.
Zipfel
Gregory J
GJ
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
Guiot
Bernard H
BH
Fessler
Richard G
RG
D000818:Animals; D001857:Bone Matrix / Q000637:transplantation; D001861:Bone Regeneration; D016723:Bone Remodeling; D016025:Bone Transplantation / Q000379:methods; D002454:Cell Differentiation; D002455:Cell Division; D002633:Chemotaxis; D019902:Chondrocytes / Q000166:cytology; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008648:Mesoderm / Q000166:cytology; D023421:Models, Animal; D010006:Osteoblasts / Q000502:physiology; D010010:Osteoclasts / Q000502:physiology; D010012:Osteogenesis; D011817:Rabbits; D013123:Spinal Fusion / Q000379:methods*; D013997:Time Factors; D014021:Tissue Preservation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous