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Updated: Jan 31, 2026

Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
ISASS Recommendations and Coverage Criteria for Bone Graft Substitutes used in Spinal Surgery
Celeste Abjornson1, Antonio Brecevich1, Tucker Callanan1
1Hospital for Special Surgery, New York, New York.
Abstract:
Autologous bone graft remains the gold standard by which bone graft substitutes are compared in spine fusion surgery. The utilization of bone graft substitutes, either as (1) an extender for spinal fusion constructs or (2) an alternative to minimize morbidity while maximizing outcomes, is changing. Moreover, current procedures technology (CPT) code 20939 became effective in 2018 defining bone marrow aspirate for bone grafting, spine surgery only. Changes in the complex landscape of grafting materials have prompted ISASS to provide category guidance for bone graft substitutes by comparing and contrasting US regulatory pathways, mechanisms of action, and supportive clinical evidence for these bone grafting materials.
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