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Spinal fusion remains a definitive treatment for patients unresponsive to conservative therapies, yet its success is challenged by age\u2010related factors such as osteoporosis, diminished stem cell function, and vascular insufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review examines current and emerging strategies to improve spinal fusion outcomes for elderly patients by analyzing advances in biomaterials, growth factor delivery systems, cell\u2010based regenerative therapies, surgical innovations, and some novel approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Advances in biomaterials, including bioactive scaffolds, 3D\u2010printed constructs, and hybrid grafts, provide structural and biological support for bone formation. Growth factor delivery systems, particularly controlled\u2010release formulations of bone morphogenetic proteins (BMPs) and vascular endothelial growth factor (VEGF), improve osteoinduction while mitigating adverse effects. Cell\u2010based regenerative therapies utilizing mesenchymal stromal cells (MSCs) and extracellular vesicles (EVs) offer promising osteogenic and immunomodulatory potential. Furthermore, minimally invasive surgical techniques and robotic\u2010assisted procedures provide additional options for enhancing spinal fusion in elderly patients. Novel approaches targeting cellular senescence, epigenetic modulation, and mitochondrial dysfunction are emerging to counteract age\u2010related impairments in bone formation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite significant advancements, challenges such as optimizing biomaterial integration, mitigating inflammatory responses, and ensuring long\u2010term stability remain. Future research should leverage precision medicine, artificial intelligence, and nanotechnology to enable patient\u2010specific fusion strategies. A multidisciplinary approach will be essential to improve spinal fusion outcomes for aging populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jsp2.70136","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:41:17Z","timestamp":1762940477000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic Approaches for Enhancing Spinal Fusion in Low Back Pain: A Review With a Focus on the Elderly"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1820-380X","authenticated-orcid":false,"given":"Shuimu","family":"Chen","sequence":"first","affiliation":[{"name":"Tissue Engineering for Orthopedics &amp; Mechanobiology (TOM), Bone &amp; Joint Program, Department for Bio\u2010Medical Research (DBMR), Faculty of Medicine University of Bern  Bern Switzerland"},{"name":"Graduate School for Cellular and Biomedical Sciences (GCB) 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