Study design: Literature review.
Objectives: This article reviews the existing data on the multiplicity of local and systemic factors affecting lumbar spinal fusion and the general biology of bone regeneration.
Summary of background data: Arthrodesis is one of the most commonly performed, yet incompletely understood, procedures in spinal surgery. There exists a paucity of knowledge about the basic biology involved in achieving a successful fusion.
Methods: Medline and manual search of all relevant articles were performed and summarized.
Results: The success or failure of spinal fusion may be influenced by a host of local and systemic factors.
Conclusions: Future research should focus on expanding our existing knowledge pertaining to the basic biology of bone regeneration specific to spinal fusion.