{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T19:36:42Z","timestamp":1782502602835,"version":"3.54.5"},"reference-count":29,"publisher":"SAGE Publications","issue":"2_suppl","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study is to analyze the complications related to multilevel anterior cervical discectomy and fusion (ACDF) using osteobiologics other than bone morphogenetic protein (BMP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of the literature was conducted using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases. The search to identify studies reporting complications in multilevel ACDF surgery using osteobiologics other than bone morphogenetic protein was performed in August 2020. The study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 584 articles were found after searching the databases and removing duplicates. Next, screening was performed in a double reviewer process, and 153 eligible articles\u2014with 4 retrospective studies\u2014in full-text were selected; these met all inclusion criteria. A total of 197 patients received 3-level ACDF, while 72 patients received 4-level ACDF. Osteobiologics were used in all selected articles, allograft was used in 4 studies, autologous bone graft was utilized in 3 articles, and hydroxyapatite was used in 1 article. The main complications reported were dysphagia, adjacent segment disease, and pseudarthrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given the limited evidence, no conclusions on complications in multilevel ACDF using osteobiologics other than BMP could be made. However, descriptively, the most common complications found were dysphagia, adjacent segment disease, and pseudoarthrosis. Further prospective studies separately analyzing complications in multilevel ACDF by osteobiologics and a number of treated levels are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231168083","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T09:53:21Z","timestamp":1709200401000},"page":"86-93","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of Complications in Multilevel Anterior Cervical Discectomy and Fusion Using Osteobiologics Other than Bone Morphogenetic Protein: A Systematic Review"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4685-6106","authenticated-orcid":false,"given":"Juan P.","family":"Cabrera","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Cl\u00ednico Regional de Concepci\u00f3n, Concepci\u00f3n, Chile"},{"name":"Faculty of Medicine, University of Concepci\u00f3n, Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-9159","authenticated-orcid":false,"given":"Mohamed Kamal","family":"Mesregah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Menoufia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6903-348X","authenticated-orcid":false,"given":"Ricardo","family":"Rodrigues-Pinto","sequence":"additional","affiliation":[{"name":"Spinal Unit (UVM). Department of Orthopaedics, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio; ICBAS - School of Medical and Biomedical Sciences; Hospital CUF Trindade, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1836-7674","authenticated-orcid":false,"given":"Yabin","family":"Wu","sequence":"additional","affiliation":[{"name":"Research Department, AO Spine, AO Foundation, Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-0643","authenticated-orcid":false,"given":"Zorica","family":"Buser","sequence":"additional","affiliation":[{"name":"Gerling Institute, Brooklyn, NY, USA"},{"name":"Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3838-1489","authenticated-orcid":false,"given":"Hans J\u00f6rg","family":"Meisel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the AO Spine Knowledge Forum Degenerative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"bibr1-21925682231168083","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00767"},{"key":"bibr2-21925682231168083","doi-asserted-by":"publisher","DOI":"10.14444\/8198"},{"key":"bibr3-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699200"},{"key":"bibr4-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.07.099"},{"key":"bibr5-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002361"},{"key":"bibr6-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699207"},{"key":"bibr7-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1177\/2192568219880176"},{"key":"bibr8-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"bibr9-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"bibr10-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000209348.17377.be"},{"key":"bibr11-21925682231168083","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2018.06.16"},{"key":"bibr12-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.07.099"},{"key":"bibr13-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.11.040"},{"key":"bibr14-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2013.09.022"},{"key":"bibr15-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-158"},{"key":"bibr16-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0351-9"},{"key":"bibr17-21925682231168083","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.SPINE14545"},{"key":"bibr18-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2817-2"},{"key":"bibr19-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-3911-4"},{"key":"bibr20-21925682231168083","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2020.01.14"},{"key":"bibr21-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10268-6"},{"key":"bibr22-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.04.073"},{"key":"bibr23-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2004.01.021"},{"key":"bibr24-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2003.05.001"},{"key":"bibr25-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2008.08.034"},{"key":"bibr26-21925682231168083","doi-asserted-by":"publisher","DOI":"10.3171\/2014.9.SPINE131005"},{"key":"bibr27-21925682231168083","doi-asserted-by":"publisher","DOI":"10.14245\/ns.1836202.101"},{"key":"bibr28-21925682231168083","doi-asserted-by":"publisher","DOI":"10.3171\/2016.1.SPINE14808"},{"key":"bibr29-21925682231168083","doi-asserted-by":"publisher","DOI":"10.1177\/2192568218792053"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682231168083","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682231168083","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682231168083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:16:31Z","timestamp":1777446991000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682231168083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":29,"journal-issue":{"issue":"2_suppl","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1177\/21925682231168083"],"URL":"https:\/\/doi.org\/10.1177\/21925682231168083","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}