{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:12:16Z","timestamp":1788491536731,"version":"build-2803163510"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The use of osteobiologics, engineered materials designed to promote bone healing by enhancing bone growth, is becoming increasingly common for spinal fusion procedures, but the efficacy of some of these products is unclear. The authors performed a retrospective, multi-institutional study to investigate the clinical and radiographic characteristics of patients undergoing single-level anterior cervical discectomy with fusion performed using the osteobiologic agent Osteocel, an allograft mesenchymal stem cell matrix.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The medical records across 3 medical centers and 12 spine surgeons were retrospectively queried for patients undergoing single-level anterior cervical discectomy and fusion (ACDF) with the use of Osteocel. Pseudarthrosis was determined based on CT or radiographic imaging of the cervical spine. Patients were determined to have radiographic pseudarthrosis if they met any of the following criteria: 1) lack of bridging bone on CT obtained &gt; 300 days postoperatively, 2) evidence of instrumentation failure, or 3) motion across the index level as seen on flexion-extension cervical spine radiographs. Univariate and multivariate analyses were then performed to identify independent preoperative or perioperative predictors of pseudarthrosis in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 326 patients met the inclusion criteria; 43 (13.2%) patients met criteria for pseudarthrosis, of whom 15 (34.9%) underwent revision surgery. There were no significant differences between patients with and those without pseudarthrosis, respectively, for patient age (54.1 vs 53.8 years), sex (34.9% vs 47.4% male), race, prior cervical spine surgery (37.2% vs 33.6%), tobacco abuse (16.3% vs 14.5%), chronic kidney disease (2.3% vs 2.8%), and diabetes (18.6% vs 14.5%) (p &gt; 0.05). Presence of osteopenia or osteoporosis (16.3% vs 3.5%) was associated with pseudarthrosis (p &lt; 0.001). Implant type was also significantly associated with pseudarthrosis, with a 16.4% rate of pseudarthrosis for patients with polyetherethereketone (PEEK) implants versus 8.4% for patients with allograft implants (p = 0.04). Average lengths of follow-up were 27.6 and 23.8 months for patients with and those without pseudarthrosis, respectively. Multivariate analysis demonstrated osteopenia or osteoporosis (OR 4.97, 95% CI 1.51\u201316.4, p &lt; 0.01) and usage of PEEK implant (OR 2.24, 95% CI 1.04\u20134.83, p = 0.04) as independent predictors of pseudarthrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In patients who underwent single-level ACDF, rates of pseudarthrosis associated with the use of the osteobiologic agent Osteocel are higher than the literature-reported rates associated with the use of alternative osteobiologics. This is especially true when Osteocel is combined with a PEEK implant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.3.focus2166","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T03:25:58Z","timestamp":1622517958000},"page":"E6","source":"Crossref","is-referenced-by-count":27,"title":["Pseudarthrosis rate following anterior cervical discectomy with fusion using an allograft cellular bone matrix: a multi-institutional analysis"],"prefix":"10.3171","volume":"50","author":[{"given":"Stephen M.","family":"Bergin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy Y.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank","family":"Rajkumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Rory","family":"Goodwin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac O.","family":"Karikari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad M.","family":"Abd-El-Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chester K.","family":"Yarbrough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoi D.","family":"Than","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"r1","series-title":"Semin Spine Surg","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1053\/j.semss.2015.11.002","article-title":"Anterior cervical discectomy and fusion: surgical indications and outcomes","volume":"28","author":"Bible JE","year":"2016","unstructured":"Bible JE, Kang JD. Anterior cervical discectomy and fusion: surgical indications and outcomes. Semin Spine Surg. 2016;28(2):80\u201383.10.1053\/j.semss.2015.11.002"},{"issue":"13","key":"r2","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E776","DOI":"10.1097\/BRS.0000000000003444","article-title":"Asymptomatic ACDF nonunions underestimate the true prevalence of radiographic pseudarthrosis","volume":"45","author":"Crawford CH III","year":"2020","unstructured":"Crawford CH III, Carreon LY, Mummaneni P,  Asymptomatic ACDF nonunions underestimate the true prevalence of radiographic pseudarthrosis. Spine (Phila Pa 1976). 2020;45(13):E776\u2013E780.10.1097\/BRS.0000000000003444"},{"issue":"20","key":"r3","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1097\/BRS.0000000000001085","article-title":"Reoperation rates for symptomatic nonunions in anterior cervical fusions from a national spine registry","volume":"40","author":"Guppy KH","year":"2015","unstructured":"Guppy KH, Harris J, Paxton LW,  Reoperation rates for symptomatic nonunions in anterior cervical fusions from a national spine registry. Spine (Phila Pa 1976). 2015;40(20):1632\u20131637.10.1097\/BRS.0000000000001085"},{"issue":"2","key":"r4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"206","DOI":"10.3171\/jns.1996.85.2.0206","article-title":"Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis","volume":"85","author":"Bishop RC","year":"1996","unstructured":"Bishop RC, Moore KA, Hadley MN. Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis. J Neurosurg. 1996;85(2):206\u2013210.10.3171\/jns.1996.85.2.02068755747"},{"issue":"22","key":"r5","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1331","DOI":"10.1097\/BRS.0000000000000557","article-title":"Osteocel Plus cellular allograft in anterior cervical discectomy and fusion: evaluation of clinical and radiographic outcomes from a prospective multicenter study","volume":"39","author":"Eastlack RK","year":"2014","unstructured":"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\u2013E1337.10.1097\/BRS.0000000000000557"},{"issue":"9","key":"r6","series-title":"Clin Spine Surg","doi-asserted-by":"publisher","first-page":"E1321","DOI":"10.1097\/BSD.0000000000000409","article-title":"Clinical and radiographic outcomes in patients undergoing single-level anterior cervical arthrodesis: a prospective trial comparing allograft to a reduced dose of rhBMP-2","volume":"30","author":"Burkus JK","year":"2017","unstructured":"Burkus JK, Dryer RF, Arnold PM, Foley KT. Clinical and radiographic outcomes in patients undergoing single-level anterior cervical arthrodesis: a prospective trial comparing allograft to a reduced dose of rhBMP-2. Clin Spine Surg. 2017;30(9):E1321\u2013E1332.10.1097\/BSD.000000000000040927352370"},{"issue":"1-2","key":"r7","series-title":"Bull Hosp Jt Dis","first-page":"13","article-title":"Osteobiologics","volume":"62","author":"Cornell CN","year":"2004","unstructured":"Cornell CN. Osteobiologics. Bull Hosp Jt Dis. 2004;62(1-2):13\u201317.15517852"},{"issue":"11","key":"r8","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"2763","DOI":"10.1016\/j.spinee.2014.05.024","article-title":"Cellular bone matrices: viable stem cell-containing bone graft substitutes","volume":"14","author":"Skovrlj B","year":"2014","unstructured":"Skovrlj B, Guzman JZ, Al Maaieh M,  Cellular bone matrices: viable stem cell-containing bone graft substitutes. Spine J. 2014;14(11):2763\u20132772.10.1016\/j.spinee.2014.05.02424929059"},{"issue":"7","key":"r9","series-title":"Eur Spine J","first-page":"2233","article-title":"A prospective clinical and radiographic 12-month outcome study of patients undergoing single-level anterior cervical discectomy and fusion for symptomatic cervical degenerative disc disease utilizing a novel viable allogeneic, cancellous, bone matrix (trinity evolution\u2122) with a comparison to historical controls","volume":"25","author":"Vanichkachorn J","year":"2016","unstructured":"Vanichkachorn J, Peppers T, Bullard D,  A prospective clinical and radiographic 12-month outcome study of patients undergoing single-level anterior cervical discectomy and fusion for symptomatic cervical degenerative disc disease utilizing a novel viable allogeneic, cancellous, bone matrix (trinity evolution\u2122) with a comparison to historical controls. Eur Spine J. 2016;25(7):2233\u20132238.26849141"},{"issue":"1","key":"r10","series-title":"J Orthop Surg Res","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s13018-017-0564-5","article-title":"Prospective clinical and radiographic evaluation of an allogeneic bone matrix containing stem cells (Trinity Evolution\u00ae Viable Cellular Bone Matrix) in patients undergoing two-level anterior cervical discectomy and fusion","volume":"12","author":"Peppers TA","year":"2017","unstructured":"Peppers TA, Bullard DE, Vanichkachorn JS,  Prospective clinical and radiographic evaluation of an allogeneic bone matrix containing stem cells (Trinity Evolution\u00ae Viable Cellular Bone Matrix) in patients undergoing two-level anterior cervical discectomy and fusion. J Orthop Surg Res. 2017;12(1):67.2844619210.1186\/s13018-017-0564-5"},{"key":"r11","series-title":"J Biomed Inform","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris PA","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL,  The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208.10.1016\/j.jbi.2019.10320831078660"},{"issue":"2","key":"r12","series-title":"Hard Tissue","first-page":"20","article-title":"Bone allograft with mesenchymal stem cells: a critical review of the literature","volume":"2","author":"Grabowski G","year":"2013","unstructured":"Grabowski G, Robertson RN. Bone allograft with mesenchymal stem cells: a critical review of the literature. Hard Tissue. 2013;2(2):20."},{"issue":"2","key":"r13","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.spinee.2015.02.037","article-title":"Mesenchymal stem cell allograft as a fusion adjunct in one- and two-level anterior cervical discectomy and fusion: a matched cohort analysis","volume":"16","author":"McAnany SJ","year":"2016","unstructured":"McAnany SJ, Ahn J, Elboghdady IM,  Mesenchymal stem cell allograft as a fusion adjunct in one- and two-level anterior cervical discectomy and fusion: a matched cohort analysis. Spine J. 2016;16(2):163\u2013167.10.1016\/j.spinee.2015.02.03725725368"},{"issue":"22","key":"r14","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1338","DOI":"10.1097\/BRS.0000000000000586","article-title":"Point of view","volume":"39","author":"Su BW","year":"2014","unstructured":"Su BW, Vaccaro AR. Point of view. Spine (Phila Pa 1976). 2014;39(22):E1338.10.1097\/BRS.0000000000000586"},{"issue":"4","key":"r15","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"562","DOI":"10.3171\/2019.9.SPINE19879","article-title":"Anterior cervical discectomy and fusion performed using structural allograft or polyetheretherketone: pseudarthrosis and revision surgery rates with minimum 2-year follow-up","volume":"32","author":"Wang M","year":"2020","unstructured":"Wang M, Chou D, Chang CC,  Anterior cervical discectomy and fusion performed using structural allograft or polyetheretherketone: pseudarthrosis and revision surgery rates with minimum 2-year follow-up. J Neurosurg Spine. 2020;32(4):562\u2013569.10.3171\/2019.9.SPINE19879"},{"issue":"45","key":"r16","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"e17935","DOI":"10.1097\/MD.0000000000017935","article-title":"Clinical and radiological results comparison of allograft and polyetheretherketone cage for one to two-level anterior cervical discectomy and fusion: a CONSORT-compliant article","volume":"98","author":"Yang S","year":"2019","unstructured":"Yang S, Yu Y, Liu X,  Clinical and radiological results comparison of allograft and polyetheretherketone cage for one to two-level anterior cervical discectomy and fusion: a CONSORT-compliant article. Medicine (Baltimore). 2019;98(45):e17935.10.1097\/MD.0000000000017935"},{"issue":"6","key":"r17","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/BRS.0000000000002854","article-title":"Cages in ACDF are associated with a higher nonunion rate than allograft: a stratified comparative analysis of 6130 patients","volume":"44","author":"Pirkle S","year":"2019","unstructured":"Pirkle S, Kaskovich S, Cook DJ,  Cages in ACDF are associated with a higher nonunion rate than allograft: a stratified comparative analysis of 6130 patients. Spine (Phila Pa 1976). 2019;44(6):384\u2013388.10.1097\/BRS.0000000000002854"},{"issue":"1","key":"r18","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3171\/2018.7.SPINE18531","article-title":"Fivefold higher rate of pseudarthrosis with polyetheretherketone interbody device than with structural allograft used for 1-level anterior cervical discectomy and fusion","volume":"30","author":"Krause KL","year":"2018","unstructured":"Krause KL, Obayashi JT, Bridges KJ,  Fivefold higher rate of pseudarthrosis with polyetheretherketone interbody device than with structural allograft used for 1-level anterior cervical discectomy and fusion. J Neurosurg Spine. 2018;30(1):46\u201351.10.3171\/2018.7.SPINE1853130485200"},{"issue":"6","key":"r19","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/S1529-9430(03)00173-6","article-title":"Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation","volume":"3","author":"Samartzis D","year":"2003","unstructured":"Samartzis D, Shen FH, Matthews DK,  Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation. Spine J. 2003;3(6):451\u2013459.10.1016\/S1529-9430(03)00173-614609689"},{"issue":"1","key":"r20","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E23","DOI":"10.1097\/BRS.0000000000002077","article-title":"What is the fate of pseudarthrosis detected 1 year after anterior cervical discectomy and fusion?","volume":"43","author":"Lee DH","year":"2018","unstructured":"Lee DH, Cho JH, Hwang CJ,  What is the fate of pseudarthrosis detected 1 year after anterior cervical discectomy and fusion? Spine (Phila Pa 1976). 2018;43(1):E23\u2013E28.10.1097\/BRS.0000000000002077"},{"key":"r21","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"100","DOI":"10.25259\/SNI-191-2019","article-title":"A review of complication rates for anterior cervical diskectomy and fusion (ACDF)","volume":"10","author":"Epstein NE","year":"2019","unstructured":"Epstein NE. A review of complication rates for anterior cervical diskectomy and fusion (ACDF). Surg Neurol Int. 2019;10:100.10.25259\/SNI-191-201931528438"},{"issue":"9","key":"r22","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1016\/j.spinee.2015.05.010","article-title":"Pseudoarthrosis rates in anterior cervical discectomy and fusion: a meta-analysis","volume":"15","author":"Shriver MF","year":"2015","unstructured":"Shriver MF, Lewis DJ, Kshettry VR,  Pseudoarthrosis rates in anterior cervical discectomy and fusion: a meta-analysis. Spine J. 2015;15(9):2016\u20132027.10.1016\/j.spinee.2015.05.01025982430"},{"issue":"3","key":"r23","series-title":"Korean J Spine","doi-asserted-by":"publisher","first-page":"114","DOI":"10.14245\/kjs.2016.13.3.114","article-title":"Surgical outcomes of anterior cervical fusion using deminaralized bone matrix as stand-alone graft material: single arm, pilot study","volume":"13","author":"Chung HJ","year":"2016","unstructured":"Chung HJ, Hur JW, Ryu KS,  Surgical outcomes of anterior cervical fusion using deminaralized bone matrix as stand-alone graft material: single arm, pilot study. Korean J Spine. 2016;13(3):114\u2013119.10.14245\/kjs.2016.13.3.11427799989"},{"issue":"2","key":"r24","series-title":"J Korean Neurosurg Soc","doi-asserted-by":"publisher","first-page":"211","DOI":"10.3340\/jkns.2015.0203.014","article-title":"Polyetheretherketone cage with demineralized bone matrix can replace iliac crest autografts for anterior cervical discectomy and fusion in subaxial cervical spine injuries","volume":"60","author":"Kim SH","year":"2017","unstructured":"Kim SH, Lee JK, Jang JW,  Polyetheretherketone cage with demineralized bone matrix can replace iliac crest autografts for anterior cervical discectomy and fusion in subaxial cervical spine injuries. J Korean Neurosurg Soc. 2017;60(2):211\u2013219.2826424210.3340\/jkns.2015.0203.014"},{"issue":"4","key":"r25","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1007\/s00586-016-4858-9","article-title":"Demineralized bone matrix in anterior cervical discectomy and fusion: a systematic review","volume":"26","author":"Zadegan SA","year":"2017","unstructured":"Zadegan SA, Abedi A, Jazayeri SB,  Demineralized bone matrix in anterior cervical discectomy and fusion: a systematic review. Eur Spine J. 2017;26(4):958\u2013974.10.1007\/s00586-016-4858-927832365"},{"issue":"5","key":"r26","series-title":"Int Orthop","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1007\/s00264-007-0378-x","article-title":"Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion","volume":"32","author":"Liao JC","year":"2008","unstructured":"Liao JC, Niu CC, Chen WJ, Chen LH. Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion. Int Orthop. 2008;32(5):643\u2013648.1763938610.1007\/s00264-007-0378-x"},{"issue":"9","key":"r27","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0203714","DOI":"10.1371\/journal.pone.0203714","article-title":"How stem cell composition in bone marrow aspirate relates to clinical outcomes when used for cervical spine fusion","volume":"13","author":"Chaput CD","year":"2018","unstructured":"Chaput CD, Shar A, Jupiter D,  How stem cell composition in bone marrow aspirate relates to clinical outcomes when used for cervical spine fusion. PLoS One. 2018;13(9):e0203714.10.1371\/journal.pone.020371430248138"},{"issue":"5","key":"r28","series-title":"Cureus","first-page":"e2636","article-title":"Efficacy of autogenous bone marrow aspirate as a fusion-promoting adjunct to anterior cervical discectomy and fusion: a single center retrospective cohort study","volume":"10","author":"Barber SM","year":"2018","unstructured":"Barber SM, Radaideh M, Parrish R. Efficacy of autogenous bone marrow aspirate as a fusion-promoting adjunct to anterior cervical discectomy and fusion: a single center retrospective cohort study. Cureus. 2018;10(5):e2636.30034958"},{"key":"r29","series-title":"Stem Cells Int","doi-asserted-by":"publisher","first-page":"3537094","DOI":"10.1155\/2017\/3537094","article-title":"Mesenchymal stem cells for the treatment of spinal arthrodesis: from preclinical research to clinical scenario","volume":"2017","author":"Salamanna F","year":"2017","unstructured":"Salamanna F, Sartori M, Brodano GB,  Mesenchymal stem cells for the treatment of spinal arthrodesis: from preclinical research to clinical scenario. Stem Cells Int. 2017;2017:3537094.2828652410.1155\/2017\/3537094"},{"issue":"6","key":"r30","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0218404","DOI":"10.1371\/journal.pone.0218404","article-title":"Evaluation of bone allograft processing methods: impact on decellularization efficacy, biocompatibility and mesenchymal stem cell functionality","volume":"14","author":"Rasch A","year":"2019","unstructured":"Rasch A, Naujokat H, Wang F,  Evaluation of bone allograft processing methods: impact on decellularization efficacy, biocompatibility and mesenchymal stem cell functionality. PLoS One. 2019;14(6):e0218404.3122011810.1371\/journal.pone.0218404"},{"issue":"407","key":"r31","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/00003086-200302000-00018","article-title":"Spine fusion using cell matrix composites enriched in bone marrow-derived cells","author":"Muschler GF","year":"2003","unstructured":"Muschler GF, Nitto H, Matsukura Y,  Spine fusion using cell matrix composites enriched in bone marrow-derived cells. Clin Orthop Relat Res. 2003;(407):102\u2013118.1256713710.1097\/00003086-200302000-00018"},{"issue":"2","key":"r1","series-title":"Semin Spine Surg","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1053\/j.semss.2015.11.002","article-title":"Anterior cervical discectomy and fusion: surgical indications and outcomes","volume":"28","author":"Bible JE","year":"2016","unstructured":"Bible JE, Kang JD. Anterior cervical discectomy and fusion: surgical indications and outcomes. Semin Spine Surg. 2016;28(2):80\u201383.10.1053\/j.semss.2015.11.002"},{"issue":"13","key":"r2","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E776","DOI":"10.1097\/BRS.0000000000003444","article-title":"Asymptomatic ACDF nonunions underestimate the true prevalence of radiographic pseudarthrosis","volume":"45","author":"Crawford CH III","year":"2020","unstructured":"Crawford CH III, Carreon LY, Mummaneni P,  Asymptomatic ACDF nonunions underestimate the true prevalence of radiographic pseudarthrosis. Spine (Phila Pa 1976). 2020;45(13):E776\u2013E780.10.1097\/BRS.0000000000003444"},{"issue":"20","key":"r3","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1097\/BRS.0000000000001085","article-title":"Reoperation rates for symptomatic nonunions in anterior cervical fusions from a national spine registry","volume":"40","author":"Guppy KH","year":"2015","unstructured":"Guppy KH, Harris J, Paxton LW,  Reoperation rates for symptomatic nonunions in anterior cervical fusions from a national spine registry. Spine (Phila Pa 1976). 2015;40(20):1632\u20131637.10.1097\/BRS.0000000000001085"},{"issue":"2","key":"r4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"206","DOI":"10.3171\/jns.1996.85.2.0206","article-title":"Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis","volume":"85","author":"Bishop RC","year":"1996","unstructured":"Bishop RC, Moore KA, Hadley MN. Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis. J Neurosurg. 1996;85(2):206\u2013210.10.3171\/jns.1996.85.2.02068755747"},{"issue":"22","key":"r5","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1331","DOI":"10.1097\/BRS.0000000000000557","article-title":"Osteocel Plus cellular allograft in anterior cervical discectomy and fusion: evaluation of clinical and radiographic outcomes from a prospective multicenter study","volume":"39","author":"Eastlack RK","year":"2014","unstructured":"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\u2013E1337.10.1097\/BRS.0000000000000557"},{"issue":"9","key":"r6","series-title":"Clin Spine Surg","doi-asserted-by":"publisher","first-page":"E1321","DOI":"10.1097\/BSD.0000000000000409","article-title":"Clinical and radiographic outcomes in patients undergoing single-level anterior cervical arthrodesis: a prospective trial comparing allograft to a reduced dose of rhBMP-2","volume":"30","author":"Burkus JK","year":"2017","unstructured":"Burkus JK, Dryer RF, Arnold PM, Foley KT. Clinical and radiographic outcomes in patients undergoing single-level anterior cervical arthrodesis: a prospective trial comparing allograft to a reduced dose of rhBMP-2. Clin Spine Surg. 2017;30(9):E1321\u2013E1332.10.1097\/BSD.000000000000040927352370"},{"issue":"1-2","key":"r7","series-title":"Bull Hosp Jt Dis","first-page":"13","article-title":"Osteobiologics","volume":"62","author":"Cornell CN","year":"2004","unstructured":"Cornell CN. Osteobiologics. Bull Hosp Jt Dis. 2004;62(1-2):13\u201317.15517852"},{"issue":"11","key":"r8","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"2763","DOI":"10.1016\/j.spinee.2014.05.024","article-title":"Cellular bone matrices: viable stem cell-containing bone graft substitutes","volume":"14","author":"Skovrlj B","year":"2014","unstructured":"Skovrlj B, Guzman JZ, Al Maaieh M,  Cellular bone matrices: viable stem cell-containing bone graft substitutes. Spine J. 2014;14(11):2763\u20132772.10.1016\/j.spinee.2014.05.02424929059"},{"issue":"7","key":"r9","series-title":"Eur Spine J","first-page":"2233","article-title":"A prospective clinical and radiographic 12-month outcome study of patients undergoing single-level anterior cervical discectomy and fusion for symptomatic cervical degenerative disc disease utilizing a novel viable allogeneic, cancellous, bone matrix (trinity evolution\u2122) with a comparison to historical controls","volume":"25","author":"Vanichkachorn J","year":"2016","unstructured":"Vanichkachorn J, Peppers T, Bullard D,  A prospective clinical and radiographic 12-month outcome study of patients undergoing single-level anterior cervical discectomy and fusion for symptomatic cervical degenerative disc disease utilizing a novel viable allogeneic, cancellous, bone matrix (trinity evolution\u2122) with a comparison to historical controls. Eur Spine J. 2016;25(7):2233\u20132238.26849141"},{"issue":"1","key":"r10","series-title":"J Orthop Surg Res","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s13018-017-0564-5","article-title":"Prospective clinical and radiographic evaluation of an allogeneic bone matrix containing stem cells (Trinity Evolution\u00ae Viable Cellular Bone Matrix) in patients undergoing two-level anterior cervical discectomy and fusion","volume":"12","author":"Peppers TA","year":"2017","unstructured":"Peppers TA, Bullard DE, Vanichkachorn JS,  Prospective clinical and radiographic evaluation of an allogeneic bone matrix containing stem cells (Trinity Evolution\u00ae Viable Cellular Bone Matrix) in patients undergoing two-level anterior cervical discectomy and fusion. J Orthop Surg Res. 2017;12(1):67.2844619210.1186\/s13018-017-0564-5"},{"key":"r11","series-title":"J Biomed Inform","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris PA","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL,  The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208.10.1016\/j.jbi.2019.10320831078660"},{"issue":"2","key":"r12","series-title":"Hard Tissue","first-page":"20","article-title":"Bone allograft with mesenchymal stem cells: a critical review of the literature","volume":"2","author":"Grabowski G","year":"2013","unstructured":"Grabowski G, Robertson RN. Bone allograft with mesenchymal stem cells: a critical review of the literature. Hard Tissue. 2013;2(2):20."},{"issue":"2","key":"r13","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.spinee.2015.02.037","article-title":"Mesenchymal stem cell allograft as a fusion adjunct in one- and two-level anterior cervical discectomy and fusion: a matched cohort analysis","volume":"16","author":"McAnany SJ","year":"2016","unstructured":"McAnany SJ, Ahn J, Elboghdady IM,  Mesenchymal stem cell allograft as a fusion adjunct in one- and two-level anterior cervical discectomy and fusion: a matched cohort analysis. Spine J. 2016;16(2):163\u2013167.10.1016\/j.spinee.2015.02.03725725368"},{"issue":"22","key":"r14","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1338","DOI":"10.1097\/BRS.0000000000000586","article-title":"Point of view","volume":"39","author":"Su BW","year":"2014","unstructured":"Su BW, Vaccaro AR. Point of view. Spine (Phila Pa 1976). 2014;39(22):E1338.10.1097\/BRS.0000000000000586"},{"issue":"4","key":"r15","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"562","DOI":"10.3171\/2019.9.SPINE19879","article-title":"Anterior cervical discectomy and fusion performed using structural allograft or polyetheretherketone: pseudarthrosis and revision surgery rates with minimum 2-year follow-up","volume":"32","author":"Wang M","year":"2020","unstructured":"Wang M, Chou D, Chang CC,  Anterior cervical discectomy and fusion performed using structural allograft or polyetheretherketone: pseudarthrosis and revision surgery rates with minimum 2-year follow-up. J Neurosurg Spine. 2020;32(4):562\u2013569.10.3171\/2019.9.SPINE19879"},{"issue":"45","key":"r16","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"e17935","DOI":"10.1097\/MD.0000000000017935","article-title":"Clinical and radiological results comparison of allograft and polyetheretherketone cage for one to two-level anterior cervical discectomy and fusion: a CONSORT-compliant article","volume":"98","author":"Yang S","year":"2019","unstructured":"Yang S, Yu Y, Liu X,  Clinical and radiological results comparison of allograft and polyetheretherketone cage for one to two-level anterior cervical discectomy and fusion: a CONSORT-compliant article. Medicine (Baltimore). 2019;98(45):e17935.10.1097\/MD.0000000000017935"},{"issue":"6","key":"r17","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/BRS.0000000000002854","article-title":"Cages in ACDF are associated with a higher nonunion rate than allograft: a stratified comparative analysis of 6130 patients","volume":"44","author":"Pirkle S","year":"2019","unstructured":"Pirkle S, Kaskovich S, Cook DJ,  Cages in ACDF are associated with a higher nonunion rate than allograft: a stratified comparative analysis of 6130 patients. Spine (Phila Pa 1976). 2019;44(6):384\u2013388.10.1097\/BRS.0000000000002854"},{"issue":"1","key":"r18","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3171\/2018.7.SPINE18531","article-title":"Fivefold higher rate of pseudarthrosis with polyetheretherketone interbody device than with structural allograft used for 1-level anterior cervical discectomy and fusion","volume":"30","author":"Krause KL","year":"2018","unstructured":"Krause KL, Obayashi JT, Bridges KJ,  Fivefold higher rate of pseudarthrosis with polyetheretherketone interbody device than with structural allograft used for 1-level anterior cervical discectomy and fusion. J Neurosurg Spine. 2018;30(1):46\u201351.10.3171\/2018.7.SPINE1853130485200"},{"issue":"6","key":"r19","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/S1529-9430(03)00173-6","article-title":"Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation","volume":"3","author":"Samartzis D","year":"2003","unstructured":"Samartzis D, Shen FH, Matthews DK,  Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation. Spine J. 2003;3(6):451\u2013459.10.1016\/S1529-9430(03)00173-614609689"},{"issue":"1","key":"r20","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E23","DOI":"10.1097\/BRS.0000000000002077","article-title":"What is the fate of pseudarthrosis detected 1 year after anterior cervical discectomy and fusion?","volume":"43","author":"Lee DH","year":"2018","unstructured":"Lee DH, Cho JH, Hwang CJ,  What is the fate of pseudarthrosis detected 1 year after anterior cervical discectomy and fusion? Spine (Phila Pa 1976). 2018;43(1):E23\u2013E28.10.1097\/BRS.0000000000002077"},{"key":"r21","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"100","DOI":"10.25259\/SNI-191-2019","article-title":"A review of complication rates for anterior cervical diskectomy and fusion (ACDF)","volume":"10","author":"Epstein NE","year":"2019","unstructured":"Epstein NE. A review of complication rates for anterior cervical diskectomy and fusion (ACDF). Surg Neurol Int. 2019;10:100.10.25259\/SNI-191-201931528438"},{"issue":"9","key":"r22","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1016\/j.spinee.2015.05.010","article-title":"Pseudoarthrosis rates in anterior cervical discectomy and fusion: a meta-analysis","volume":"15","author":"Shriver MF","year":"2015","unstructured":"Shriver MF, Lewis DJ, Kshettry VR,  Pseudoarthrosis rates in anterior cervical discectomy and fusion: a meta-analysis. Spine J. 2015;15(9):2016\u20132027.10.1016\/j.spinee.2015.05.01025982430"},{"issue":"3","key":"r23","series-title":"Korean J Spine","doi-asserted-by":"publisher","first-page":"114","DOI":"10.14245\/kjs.2016.13.3.114","article-title":"Surgical outcomes of anterior cervical fusion using deminaralized bone matrix as stand-alone graft material: single arm, pilot study","volume":"13","author":"Chung HJ","year":"2016","unstructured":"Chung HJ, Hur JW, Ryu KS,  Surgical outcomes of anterior cervical fusion using deminaralized bone matrix as stand-alone graft material: single arm, pilot study. Korean J Spine. 2016;13(3):114\u2013119.10.14245\/kjs.2016.13.3.11427799989"},{"issue":"2","key":"r24","series-title":"J Korean Neurosurg Soc","doi-asserted-by":"publisher","first-page":"211","DOI":"10.3340\/jkns.2015.0203.014","article-title":"Polyetheretherketone cage with demineralized bone matrix can replace iliac crest autografts for anterior cervical discectomy and fusion in subaxial cervical spine injuries","volume":"60","author":"Kim SH","year":"2017","unstructured":"Kim SH, Lee JK, Jang JW,  Polyetheretherketone cage with demineralized bone matrix can replace iliac crest autografts for anterior cervical discectomy and fusion in subaxial cervical spine injuries. J Korean Neurosurg Soc. 2017;60(2):211\u2013219.2826424210.3340\/jkns.2015.0203.014"},{"issue":"4","key":"r25","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1007\/s00586-016-4858-9","article-title":"Demineralized bone matrix in anterior cervical discectomy and fusion: a systematic review","volume":"26","author":"Zadegan SA","year":"2017","unstructured":"Zadegan SA, Abedi A, Jazayeri SB,  Demineralized bone matrix in anterior cervical discectomy and fusion: a systematic review. Eur Spine J. 2017;26(4):958\u2013974.10.1007\/s00586-016-4858-927832365"},{"issue":"5","key":"r26","series-title":"Int Orthop","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1007\/s00264-007-0378-x","article-title":"Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion","volume":"32","author":"Liao JC","year":"2008","unstructured":"Liao JC, Niu CC, Chen WJ, Chen LH. Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion. Int Orthop. 2008;32(5):643\u2013648.1763938610.1007\/s00264-007-0378-x"},{"issue":"9","key":"r27","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0203714","DOI":"10.1371\/journal.pone.0203714","article-title":"How stem cell composition in bone marrow aspirate relates to clinical outcomes when used for cervical spine fusion","volume":"13","author":"Chaput CD","year":"2018","unstructured":"Chaput CD, Shar A, Jupiter D,  How stem cell composition in bone marrow aspirate relates to clinical outcomes when used for cervical spine fusion. PLoS One. 2018;13(9):e0203714.10.1371\/journal.pone.020371430248138"},{"issue":"5","key":"r28","series-title":"Cureus","first-page":"e2636","article-title":"Efficacy of autogenous bone marrow aspirate as a fusion-promoting adjunct to anterior cervical discectomy and fusion: a single center retrospective cohort study","volume":"10","author":"Barber SM","year":"2018","unstructured":"Barber SM, Radaideh M, Parrish R. Efficacy of autogenous bone marrow aspirate as a fusion-promoting adjunct to anterior cervical discectomy and fusion: a single center retrospective cohort study. Cureus. 2018;10(5):e2636.30034958"},{"key":"r29","series-title":"Stem Cells Int","doi-asserted-by":"publisher","first-page":"3537094","DOI":"10.1155\/2017\/3537094","article-title":"Mesenchymal stem cells for the treatment of spinal arthrodesis: from preclinical research to clinical scenario","volume":"2017","author":"Salamanna F","year":"2017","unstructured":"Salamanna F, Sartori M, Brodano GB,  Mesenchymal stem cells for the treatment of spinal arthrodesis: from preclinical research to clinical scenario. Stem Cells Int. 2017;2017:3537094.2828652410.1155\/2017\/3537094"},{"issue":"6","key":"r30","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0218404","DOI":"10.1371\/journal.pone.0218404","article-title":"Evaluation of bone allograft processing methods: impact on decellularization efficacy, biocompatibility and mesenchymal stem cell functionality","volume":"14","author":"Rasch A","year":"2019","unstructured":"Rasch A, Naujokat H, Wang F,  Evaluation of bone allograft processing methods: impact on decellularization efficacy, biocompatibility and mesenchymal stem cell functionality. PLoS One. 2019;14(6):e0218404.3122011810.1371\/journal.pone.0218404"},{"issue":"407","key":"r31","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/00003086-200302000-00018","article-title":"Spine fusion using cell matrix composites enriched in bone marrow-derived cells","author":"Muschler GF","year":"2003","unstructured":"Muschler GF, Nitto H, Matsukura Y,  Spine fusion using cell matrix composites enriched in bone marrow-derived cells. Clin Orthop Relat Res. 2003;(407):102\u2013118.1256713710.1097\/00003086-200302000-00018"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/50\/6\/article-pE6.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/50\/6\/article-pE6.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/50\/6\/article-pE6.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T08:20:21Z","timestamp":1779524421000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/50\/6\/article-pE6.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":62,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2021.3.focus2166","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}