The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Application of bone repair material containing recombinant human bone morphogenetic protein-2 in instrumented posterior lumbar interbody fusion

Author : LEI Jian-ping, XU Hao, ZHANG Ke-liang.     
Working unit : Wuhan Puai Hospital, Wuhan 430033,China
Page : 390-394
Key words : recombinant human bone morphogenetic protein-2, bone autograft, posterior lumbar interbody fusion

    Abstract:

Objective

To investigate the clinical outcomes of applying bone repair material containing recombinant human bone morphogenetic protein-2 (rhBMP-2) in instrumented posterior lumbar interbody fusion.

Methods

Form January 2015 to April 2016, 73 patients with lumbar degenerative diseases were surgically treated with instrumented posterior lumbar interbody fusion in our hospital. According to the materials implanted into the cages for posterior lumbar interbody fusion combined with bilateral pedicle screw-rod fixation, the 73 patients were divided into two groups: the rhBMP-2 group had the bone repair  material containing rhBMP-2 filled in the interbody cage in 35 patients, whereas the bone autograft group had autogenous bone was packed in the cage in 38 patients. The operative time, intraoperative blood loss, ODI, JOA and radiological assessments, such as the screw malposition, loss of intervertebral height, cage displacement as well as intervertebral fusion, were  compared between the two groups.

Results

There were no statistical differences in the operative time, intraoperative blood loss, ODI  and JOA between the two groups (P>0.05) . The rhBMP-2 group was significantly inferior to the bone autograft group at 12 weeks after operation with higher rate of the screw malposition (7.14% versus 2.29% ) and higher rate of the cage displacement (8.11% versus 2.56%) (P<0.05) , however, which turned to be statistically indistinguishable at 24 weeks postoperatively (9.29% versus 10.53% and 8.11% versus 7.69%) (P>0.05) . Conversely, the rhBMP-2 group got significantly less intervertebral height loss than the bone autograft group [(0.32±0.06) mm versus (1.41± 0.40) mm, P<0.05] . In term of the intervertebral fusion rate, the rhBMP- 2 group was statistically inferior to the bone autograft group at 12 weeks after operation(54.05% versus 79.49%, P<0.05) , although both groups achieved 100% of the fusion at 24 weeks after operation (P>0.05) .

Conclusion

The onset time of the bone repair material containing rhBMP-2 is later than the autologous bone, despite the fact that the material with rhBMP-2 get similar final fusion rate, and better recovery of intervertebral height than the autologous bone. This indicates that the material with rhBMP-2 is effective alternative to autologous bone for spinal fusion.


summary:
Application of bone repair material containing recombinant human bone morphogenetic protein-2 in instrumented posterior lumbar interbody fusion   
LEI Jian-ping, XU Hao, ZHANG Ke-liang.
Orthop J Chin,2018,26(5):   390-394