In vivo evaluation of recombinant human osteogenic protein (rhOP-1) implants as a bone graft substitute for spinal fusions.
METHODS
Posterior spinal fusion segments were evaluated in adult mongrel dogs at 6, 12, and 26 weeks post-implantation. Four sites on each animal received implants consisting of recombinant human osteogenic protein-1 on a bone collagen carrier, bone collagen carrier alone, autogenous iliac crest bone, or no implant material.


OBJECTIVE
To determine the efficacy of recombinant human osteogenic protein-1 as a bone graft substitute in achieving posterior spinal fusion and compare the results to those obtained using autogenous bone graft.


BACKGROUND
Posterior spinal fusion generally includes onlay grafting of autogenous or allogeneic bone after decortication of bony surfaces of the vertebral elements. The search for an acceptable bone graft substitute material has in recent years centered upon proteins capable of inducing bone in vivo. Recombinant human osteogenic protein-1 has demonstrated efficacy in healing large segmental osteoperiosteal defects in rabbits, dogs, and monkeys and appears ideally suited as a bone graft substitute for spinal fusions.


METHODS
The quality of fusion and new bone formation was evaluated using plain films, computed tomography, and magnetic resonance imaging.


RESULTS
Radiographic and histologic studies demonstrated that recombinant human osteogenic protein-1-treated fusion segments attained a stable fusion by 6 weeks post-implantation and were completely fused by 12 weeks. The autograft sites demonstrated fusion at 26 weeks post-implantation.


CONCLUSIONS
The results indicated that recombinant human osteogenic protein-1 is an effective bone graft substitute for achieving stable posterior spinal fusions in a significantly more rapid fashion than can be achieved with autogenous bone graft.
Department of Orthopaedic Surgery, Tulane School of Medicine, New Orleans, Louisiana.
S D
SD
Cook
J E
JE
Dalton
E H
EH
Tan
T S
TS
Whitecloud
D C
DC
Rueger
D000818:Animals; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D016025:Bone Transplantation; D003094:Collagen / Q000008:administration & dosage; D004285:Dogs; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D019736:Prostheses and Implants; D011506:Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013123:Spinal Fusion / Q000379:methods*; D013314:Stress, Mechanical; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016212:Transforming Growth Factor beta / Q000008:administration & dosage / Q000627:therapeutic use*
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D011506:Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; D003094:Collagen