title: Bone graft and bone graft substitutes in spine surgery: current concepts and controversies.
abstract: Iliac crest bone graft has long been the standard adjunct used in spine fusion surgery. This graft provides osteogenic, osteoinductive, and osteoconductive elements that aid in creation of a fusion mass. However, morbidity associated with bone graft harvest has led surgeons to seek other potential adjuncts, including bone morphogenetic proteins, demineralized bone matrix, and graft expanders such as synthetic bone graft and allograft. Knowledge of fusion biology is required to understand the benefits and limitations of these agents, which promote fusion via one of four mechanisms: osteogenesis, osteoinduction, osteoconduction, and osteopromotion. Although bone morphogenetic proteins have shown a clear ability to aid in bone formation and successful fusion, recent concern regarding their safety has tempered enthusiasm regarding their use.
authors.affiliation: Department of Orthopaedic Surgery and Sports Medicine, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Grabowski
authors.forename: Chris A
authors.initials: CA
authors.lastname: Cornett
mesh_terms: D001857:Bone Matrix / Q000737:chemistry; D055396:Bone Morphogenetic Protein 2 / Q000032:analysis; D055419:Bone Morphogenetic Protein 7 / Q000032:analysis; D001861:Bone Regeneration; D018786:Bone Substitutes; D016025:Bone Transplantation; D006801:Humans; D007085:Ilium / Q000601:surgery*; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D055419:Bone Morphogenetic Protein 7; D018786:Bone Substitutes