{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:28:58Z","timestamp":1777660138801,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess global practices and preferences in the use of osteobiologics for anterior cervical discectomy and fusion (ACDF) and identify factors influencing the choice of specific osteobiologics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online survey developed by AO Spine was distributed to spine surgeons worldwide. The survey captured demographic characteristics, osteobiologic use and related information (i.e., previous training, practice patterns, etc.), and factors influencing osteobiologic choice in ACDF. Descriptive statistics, Chi-square tests, and multiple logistic regression were used to analyze responses, focusing on the associations between osteobiologic use and variables such as training, cost awareness, and regional practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Responses from 458 surgeons revealed regional variability in osteobiologic preferences. Autologous iliac crest bone graft (AICBG) was predominant in Asia Pacific and Middle East, while allograft and demineralized bone matrix were favored in North America and Latin America (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001). Over half of the respondents (79.7%) lacked formal training in osteobiologics, and 53.1% were unaware of related costs. Surgeons residing in the Asia Pacific region (OR: 0.47, 95% CI: 0.26-0.84,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0114), without formal training (OR: 0.53, 95% CI: 0.29-0.97,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0429), or using cages less often (OR: 0.15, 95% CI: 0.06-0.34,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001) were less likely to utilize osteobiologics. Osteobiologic use was also more common when related costs were not an issue for the practitioner (OR: 2.32, 95% CI:1.47-3.70,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant variation exists in osteobiologic use in ACDF across global regions, influenced by surgeon training, cost awareness, and institutional resources. Enhanced training and guidelines could improve consistency in osteobiologic application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251322417","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T03:53:06Z","timestamp":1739937186000},"page":"3262-3272","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Practices and Preferences in the Use of Osteobiologics for Anterior Cervical Discectomy and Fusion: A Cross-Sectional Study"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2424-1274","authenticated-orcid":false,"given":"Luca","family":"Ambrosio","sequence":"first","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy"},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6322-4357","authenticated-orcid":false,"given":"Arun Kumar","family":"Viswanadha","sequence":"additional","affiliation":[{"name":"Reva Spine Centre, Visakhapatnam, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter-Paul A.","family":"Vergroesen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Noordwest Hospitals, Alkmaar, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-0643","authenticated-orcid":false,"given":"Zorica","family":"Buser","sequence":"additional","affiliation":[{"name":"Gerling Institute, New York City, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3838-1489","authenticated-orcid":false,"given":"Hans Joerg","family":"Meisel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Santesso","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason P. Y.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9111-9060","authenticated-orcid":false,"given":"Hai V.","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Vadal\u00e0","sequence":"additional","affiliation":[{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy"},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-3365","authenticated-orcid":false,"given":"Amit","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2004-9448","authenticated-orcid":false,"given":"Andreas K.","family":"Demetriades","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Edinburgh Spinal Surgery Outcome Studies Group, Royal Infirmary Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7511-2486","authenticated-orcid":false,"given":"Sam K.","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-4842","authenticated-orcid":false,"given":"Patrick C.","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Sacramento, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish D.","family":"Diwan","sequence":"additional","affiliation":[{"name":"Spine Labs, St George and Sutherland Clinical School, University of New South Wales, Kogarah, NSW, Australia"},{"name":"Spine Service, Department of Orthopaedic Surgery, St George and Sutherland Clinical School, University of New South Wales, Kogarah, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1010-6952","authenticated-orcid":false,"given":"Tim","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7143-4354","authenticated-orcid":false,"given":"Sathish","family":"Muthu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Orthopedic Research Group, Coimbatore, India"},{"name":"Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore, India"},{"name":"Department of Orthopaedics, Government Medical College, Karur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"AO Spine Knowledge Forum Degenerative","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002273"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682231156865"},{"key":"e_1_3_6_4_2","first-page":"137","article-title":"Biotechnologies and biomaterials in spine surgery","volume":"29","author":"Vadala G","year":"2015","unstructured":"Vadala G, Russo F, Ambrosio L, et al. Biotechnologies and biomaterials in spine surgery. J Biol Regul Homeost Agents. 2015;29:137-147.","journal-title":"J Biol Regul Homeost Agents"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200301150-00008"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.1.SPINE151005"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220948479"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2011.5.3.169"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682221133751"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682221148139"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699200"},{"key":"e_1_3_6_12_2","unstructured":"Fortune business insights. Orthobiologics market size share & industry analysis by product type (viscosupplements bone growth factors demineralized bone matrix (DBM) synthetic bone substitutes cellular allograft allografts and others) by application (spinal fusion maxillofacial & dental soft tissue repair reconstructive & fracture surgery and others) by end-user (Hospitals & ASCs Specialty Clinics and Others) and Regional Forecast 2024-2032. 2024;1:1."},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682231178204"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181ce11cc"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/ten.teb.2015.0357"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682231188626"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.14444\/8560"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001022"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.5435\/jaaos-d-22-00085"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07897-w"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.01.002"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682231180396"},{"key":"e_1_3_6_23_2","unstructured":"NASS. Coverage recommendations. https:\/\/www.spine.org\/Coverage. accessed on 21 January 2025."}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682251322417","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682251322417","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682251322417","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:21:38Z","timestamp":1777447298000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682251322417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,19]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/21925682251322417"],"URL":"https:\/\/doi.org\/10.1177\/21925682251322417","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,19]]}}}