INTRODUCTION
by Celeste Abjornson, PhD, and Vijay K. Goel, PhD
Bone graft substitutes is a general term to describe any
material used to aid in regeneration of bone, such as in a
fracture, or in promotion of bone, such as in a spine fusion.
There is a wide spectrum of materials used today for the
purpose of grafting; however, their ultimate goal remains
the same-to form functionally viable bone that meets the
needs of the site.
The first known bone grafting procedure documented in
modern medicine was described in the early nineteenth
century and used what is still considered by some the gold
standard, autograft. In the early 1990s, demineralized
bone matrix and processed structural allografts became
commercially available. In 2002, the first bone morphogenic
protein became available with the FDA clearance of rhBMP-
2 on a type-I collagen sponge in conjunction with a tapered,
threaded intervertebral fusion cage (LT-Cage; Medtronic
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Sofamor Danek, Minneapolis, Minnesota) for the indication of
degenerative lumbar disc disease.
Today, there is a plethora of options available-calcium-based,
collagen-based, polymer, allograft, synthetic proteins-and the
list goes on. But the difficulty lies in applying these materials in
the right indications. Spine surgery is also in a period of great
flux with new technologies exploding into the market. The
question of how to pair these new materials for grafting with
these surgical options is largely not well understood. The goal
of this symposium is to ask experts in the field of bone graft
substitutes what the standards of today are and how they should
be applied to the technologies of tomorrow. We would like to
thank our panel for their interesting and candid answers to the
thought-provoking questions below.

Key Words
SAS Journal. Winter 2008. 2:55–61. DOI: SASJ-2008-Symposium1
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