Pediatric spinal fusions have been associated with nonunion rates of approximately 25%, putting patients at risk for neurological complications while simultaneously incurring significant costs for revision surgery. In an effort to decrease nonunion rates, various bone grafts and biologics have been developed to increase osseous formation and arthrosis. The current gold-standard bone graft is autologous bone taken from the iliac crest or ribs, but this procedure is associated with significant morbidity and postoperative pain due to an additional graft harvesting procedure. Other bone graft substitutes and biologics include allografts, demineralized bone matrix, bone morphogenetic protein, and bioactive glass. Ultimately, these substitutes have been studied more extensively in the adult population, and there is a paucity of strong evidence for the use of these agents within the pediatric population. In this review, the authors will discuss in detail the characteristics of the various bone graft substitutes, their fusion efficacy, and their safety profile in this subpopulation.

小儿脊柱融合术与大约 25% 的骨不连率相关，使患者面临神经系统并发症的风险，同时会产生大量的翻修手术费用。为了降低骨不连率，已经开发了各种骨移植物和生物制剂以增加骨形成和关节形成。目前的金标准骨移植物是取自髂嵴或肋骨的自体骨，但由于额外的移植物采集过程，该过程与显着的发病率和术后疼痛有关。其他骨移植替代品和生物制剂包括同种异体移植物、脱矿骨基质、骨形态发生蛋白和生物活性玻璃。最终，这些替代品在成年人群中得到了更广泛的研究，并且缺乏强有力的证据表明在儿科人群中使用这些药物。在这篇综述中，作者将详细讨论各种骨移植替代物的特征、它们的融合效果以及它们在该亚群中的安全性。