A composite bone graft (1) for implantation in a patient, to methods of making, and using the composite bone graft along with methods for treating patients by implanting the composite bone graft at a site in a patient. The composite bone graft includes two or more connected, discrete, bone portions (2-4), and includes one or more bio-compatible connectors (7) which hold together the discrete bone portions (2-4) to form the composite bone graft (1). The composite bone graft (1) may include one or more textured bone surfaces (14b). The textured surface (14a, 14b) preferably includes a plurality of closely spaced protrusions, preferably closely spaced continuous protrusions. The composite bone graft (1) is useful for repairing bone defects caused by congenital anomaly, disease, or trauma in a patient, for example, for restoring vertical support of the anterior, and/or posterior column. Implantation of the composite bone graft results in improved graft stability, and osteo-induction ability, without a decrease in mechanical strength.
