The use of small molecules to aid with spinal fusion

The objective of this review article is to summarize the rationale and the literature on the use of small molecules in spine fusion. As opposed to recombinant proteins or even antibodies, the small size of pharmacologic small molecules affords them many unique advantages. Although the literature remains sparse on this subject as it pertains to spinal fusion, there is mounting evidence that small molecules can be effective at increasing bone formation by modulating a variety of biologic signaling cascades in bone. While there is still much work to be done in this field before it is ready to make a clinical impact, pharmacologic small molecules remain a very promising strategy for achieving consistently successful spine fusions.