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Alec W. Gibson, Abdullah H. Feroze, Madeline E. Greil, Margaret E. McGrath, Sananthan Sivakanthan, Gabrielle A. White-Dzuro, John R. Williams, Christopher C. Young, and Christoph P. Hofstetter

revision or multilevel spine surgery, there is a dearth of biologic options available to assist with fusion. These include autograft harvest and allograft with materials such as recombinant human bone morphogenetic protein (rhBMP). However, autologous bone graft is associated with harvest site–related morbidity and increased operative time. 13 , 14 Additionally, rhBMP-2 has a narrow therapeutic window and is associated with potentially severe complications, 15–21 resulting in an FDA warning against its use in the cervical spine. 22 The cellular allograft utilized for

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Ryan R. Diaz, Amey R. Savardekar, Jared R. Brougham, Danielle Terrell, and Anthony Sin

January 2001 to December 2020 in PubMed, the Cochrane Library database, Scopus, and Web of Science. A combination of keywords was used to build a search strategy. Only English-language articles were searched. Keywords used to build the search directory were ["cellular bone matrix" OR “viable bone matrix” OR “cellular allograft” OR “stem-cell based allograft” OR “allograft cellular bone matrix”] AND [“spine surgery” OR “spinal fusion” OR “spine fusion”] AND [“efficacy” OR “effectiveness”]. We included all human as well as animal studies that used ACBMs as a bone

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Adarsh K. Gulati and Geoffrey P. Cole

Table 1 . The recovery of target EDL muscle after each type of nerve repair and of normal EDL muscle is shown in Fig. 1 . The individual weights of six normal muscles were 94, 87, 92, 92, 86, and 94 mg. A more detailed description of results for each graft type is given below. TABLE 1 Relative presence of mononuclear immune cells in different regions of various types of nerve grafts * Weeks After Transplantation Graft Type and Region Cellular Isografts Cellular Allografts Acellular Isografts Acellular

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Allan D. Levi, Christopher I. Shaffrey, Regis W. Haid, Scott D. Boden, Michelle J. Clarke, and Marcus D. Mazur

looking at the spinal surgery landscape. The current issue of Neurosurgical Focus focuses on the clinical indications, safety, cost, and surgical outcomes of many commonly used spine osteobiologics on the market. Insights are provided on a range of topics, including dosage, cost, and use of bone morphogenetic protein to treat pediatric patients and those with deformity, as well as the use of cellular allograft materials and bone graft substitutes. An excellent review of the impact of medications used to treat osteoporosis in the perioperative fusion period is also

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Junseok Bae, Alexander A. Theologis, Russell Strom, Bobby Tay, Shane Burch, Sigurd Berven, Praveen V. Mummaneni, Dean Chou, Christopher P. Ames, and Vedat Deviren

decompression in the coronal deformities. After docking on the lateral annulus and placing a tubular retractor via the transpsoas approach, discectomy and release of the far side of the annulus was performed, followed by implantation of the polyetheretherketone cage, which included cellular allograft. TLIF was performed at the L5–S1 level during the subsequent posterior approach. For ALIF, the patient was placed in the supine position. After fluoroscopic identification of the index level, a midline skin incision was made. A retroperitoneal approach to the appropriate disc

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Yagiz Ugur Yolcu, Waseem Wahood, Abdullah T. Eissa, Mohammed Ali Alvi, Brett A. Freedman, Benjamin D. Elder, and Mohamad Bydon

Biomater Appl . 2016 ; 31 ( 4 ): 477 – 487 . 40 Eastlack RK , Garfin SR , Brown CR , Meyer SC . Osteocel Plus cellular allograft in anterior cervical discectomy and fusion: evaluation of clinical and radiographic outcomes from a prospective multicenter study . Spine (Phila Pa 1976) . 2014 ; 39 ( 22 ): E1331 – E1337 . 41 Tohmeh AG , Watson B , Tohmeh M , Zielinski XJ . Allograft cellular bone matrix in extreme lateral interbody fusion: preliminary radiographic and clinical outcomes . ScientificWorldJournal . 2012 ; 2012 : 263637 . 42 Molinari

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Daniel J. Guillaume, Stephen L. Huhn, Nathan R. Selden, and Robert D. Steiner

transplantation to trials using highly purified and expanded NSC allografts is uncertain. The immunogenicity of fetal dopaminergic cells has not been systematically compared to that of neural stem/progenitor cells. Nonetheless, the presence of allograft cells well beyond the time of transplantation supports the concept of prolonged engraftment and possibly long-term CNS immunotolerance, enhancing the therapeutic potential of CNS cellular transplants in the clinical setting. The ability to achieve prolonged survival of functional CNS cellular allografts will depend on

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Stephen M. Bergin, Timothy Y. Wang, Christine Park, Shashank Rajkumar, C. Rory Goodwin, Isaac O. Karikari, Muhammad M. Abd-El-Barr, Christopher I. Shaffrey, Chester K. Yarbrough, and Khoi D. Than

. Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis . J Neurosurg . 1996 ; 85 ( 2 ): 206 – 210 . 5 Eastlack RK , Garfin SR , Brown CR , Meyer SC . Osteocel Plus cellular allograft in anterior cervical discectomy and fusion: evaluation of clinical and radiographic outcomes from a prospective multicenter study . Spine (Phila Pa 1976) . 2014 ; 39 ( 22 ): E1331 – E1337 . 6 Burkus JK , Dryer RF , Arnold PM , Foley KT . Clinical and radiographic outcomes in patients

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Russell G. Strom, Junseok Bae, Jun Mizutani, Frank Valone III, Christopher P. Ames, and Vedat Deviren

exposure. Following discectomy and trial placement, a 10° lordotic implant of maximum safe size was chosen. The polyetheretherketone cage was filled with cellular allograft and inserted into the disc space. Scoliosis radiographs were obtained between stages to gauge the remaining correction needed. For posterior surgery, the patient was positioned prone on a Jackson table with his or her thighs extended to promote LL. Interspinous ligament resection and Schwab 27 Grade 1 facet osteotomies were performed from L-1 to S-1. Additional bone resection (Grade 2 Ponte

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Spencer C. Darveau, Owen P. Leary, Elijah M. Persad-Paisley, Elias A. Shaaya, Adetokunbo A. Oyelese, Jared S. Fridley, Prakash Sampath, Joaquin Q. Camara-Quintana, Ziya L. Gokaslan, and Tianyi Niu

transforaminal lumbar interbody fusion . Clin Neurol Neurosurg . 2013 ; 115 ( 7 ): 991 – 994 . 23 Tohmeh AG , Watson B , Tohmeh M , Zielinski XJ . Allograft cellular bone matrix in extreme lateral interbody fusion: preliminary radiographic and clinical outcomes . ScientificWorldJournal . 2012 ; 2012 263637 . 24 Eastlack RK , Garfin SR , Brown CR , Meyer SC . Osteocel Plus cellular allograft in anterior cervical discectomy and fusion: evaluation of clinical and radiographic outcomes from a prospective multicenter study . Spine (Phila Pa 1976