Advances in osteobiologics in spine surgery.
In spine surgery, fixation devices that revolutionized spinal fusion are becoming mature technologies, and new tools derived from biologics are becoming more important in clinical practice. Thus, surgeons need to become more sophisticated in evaluating and using these new biologics, which are rapidly entering the market. The majority of these biologics are aimed at enhancing spinal fusion and can be called osteobiologics. Osteobiologic products vary from recombinant proteins to specially prepared allograft or autograft materials. Their financial costs are considerable, and the level of proof for the efficacy and safety of these products varies widely. In this article, I delineate useful principles that can be used to evaluate current and future generations of osteobiologic products, and I discuss the most pertinent examples of specific osteobiologics.
Yoon
S Tim
ST
Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia, USA. tim.yoon@emoryhealthcare.org
D001672:Biocompatible Materials / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use*; D001857:Bone Matrix; D055396:Bone Morphogenetic Protein 2; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D016025:Bone Transplantation; D055428:Growth Differentiation Factor 5; D006801:Humans; D013122:Spinal Diseases / Q000601:surgery*; D016212:Transforming Growth Factor beta / Q000627:therapeutic use
C525718:BMP2 protein, human; C525819:BMP7 protein, human; D001672:Biocompatible Materials; D001688:Biological Products; D055396:Bone Morphogenetic Protein 2; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; C525893:GDF5 protein, human; D055428:Growth Differentiation Factor 5; D016212:Transforming Growth Factor beta