Safe under FDA-approved recommendations (i.e., one-level anterolateral interbody fusion surgery with an LT-cage); Low complications (subsidence, cancer, infection); Equal efficiency (fusion rate, pain disability, patient satisfaction, risk of re-operations) between BMP-2, allogenic or autologous bone graft; Safety and effectiveness of BMP-2 in off-label use: not established. The gene discussed is BMP2; the disease is cancer.