Recent Research Advances in Biologic Bone Graft Materials for Spine Surgery.

PURPOSE OF REVIEW: Biologic bone graft materials continue to be an important component of various spinal fusion procedures. Given the known risks and morbidity of harvesting iliac crest bone graft, the historical gold standard for spinal fusion, these biologic materials serve the purpose of improving both the efficacy and safety of spinal fusion procedures. Recent advances in biomedical and materials sciences have enabled the design of many novel materials that have shown promise as effective bone graft materials. This review will discuss current research pertaining to several of these materials, including functionalized peptide amphiphiles and other nanocomposites, novel demineralized bone matrix applications, 3D-printed materials, and Hyperelastic Bone®, among others. RECENT
FINDINGS: Recent investigation has demonstrated that novel technologies, including nanotechnology and 3D printing, can be used to produce biomaterials with significant osteogenic potential. Notably, peptide amphiphile nanomaterials functionalized to bind BMP-2 have demonstrated significant bone regenerative capacity in a pre-clinical rodent posterolateral lumbar fusion (PLF) model. Additionally, 3D-printed Hyperelastic Bone® has demonstrated promising bone regenerative capacity in several in vivo animal models. Composite materials such as TrioMatrix® (demineralized bone matrix, hydroxyapatite, and nanofiber-based collagen scaffold) have also demonstrated significant osteogenic potential in both in vitro and in vivo settings. Advances in materials science and engineering have allowed for the design and implementation of several novel biologic materials, including nanocomposites, 3D-printed materials, and various biologic composites. These materials provide significant bone regenerative capacity and have the potential to be alternatives to other bone graft materials, such as autograft and BMP-2, which have known complications.