Spine surgery continues to be an exciting and dynamic subspecialty of orthopaedic surgery. Biologic enhancement of fusion and disc arthroplasty are two of the "hottest" areas undergoing investigation. Both basic science and clinical research into the role of bone morphogenetic proteins (BMPs) and molecular biological applications in the spine are ongoing. BMP has been approved by the United States Food and Drug Administration (FDA) for use in the LT lumbar fusion cage (Medtronic Sofamor Danek, Memphis, Tennessee). Patient enrollment has been completed for the trial of the one-level SB Charité artificial lumbar disc (Link Spine Group, Branford, Connecticut), and clinical trials of the one and two-level ProDisc (Spine Solutions, New York, NY) will close in 2003. FDA submissions for approval may be made as early as December 2003 for the Charité device. Clinical trials of the Bryan Cervical Disc (Spinal Dynamics, Mercer Island, Washington) started in the United States this year, and investigational device studies may be launched on several more cervical and lumbar arthroplasty designs within the next six to twelve months.