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Complications and Concerns With Osteobiologics for Spine Fusion in Clinical Practice

Glassman, Steven D. MD*†; Howard, Jennifer M. MPH‡; Sweet, Alexander BS‡; Carreon, Leah Y. MD, MSc†

doi: 10.1097/BRS.0b013e3181ce11cc
Bone Grafting Techniques

Study Design. Literature-based topic review.

Objective. To review the complications and the concerns that may be associated with all of the commonly used osteobiologic options for spine fusion.

Summary of Background Data. Obtaining a solid arthrodesis is an important objective in many lumbar surgical procedures, and a wide array of bone graft materials may be used in an attempt to achieve this goal. Iliac crest bone graft, as well as all of the available osteobiologic alternatives, carries potential risks and concerns for both patient and surgeon.

Methods. Review of literature and expert opinion.

Conclusion. Some of the potential complications associated with osteobiologic materials used in spinal fusion are well understood and clearly documented whereas others require further study and clarification. In any given clinical situation, the patient and surgeon need to balance the benefits and performance characteristics of the graft material with the risk profile to optimize clinical management.

Iliac crest bone graft, as well as all of the available osteobiologic alternatives, carries potential risks and concerns for both patient and surgeon. The patient and surgeon need to balance the benefits and performance characteristics of the graft materials with the risk profile to optimize clinical decision-making.

From the *Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY; †Norton Leatherman Spine Center, Louisville, KY; and ‡University of Louisville, School of Medicine, Louisville, KY.

The device(s)/drug(s) that is/are the subject of the manuscript is/are not FDA-approved for this indication and is/are not commercially available in the United States.

No funds were received in support of this work. Although one or more of the author(s) has/have received/will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript, benefits will be directed solely to a research fund, foundation, educational institution, or other nonprofit organization which the author(s) has/have been associated.

Address correspondence and reprint requests to Steven D. Glassman, MD, 210 East Gray St, Suite 900, Louisville, KY 40202; E-mail: tana.allgeyer@nortonhealthcare.com

© 2010 Lippincott Williams & Wilkins, Inc.