The use of recombinant human bone morphogenic protein in posterior interbody fusions of the lumbar spine: a clinical series.
METHODS
A 48 patient clinical series investigated posterior lumbar interbody fusions (PLIFs) incorporating bone morphogenic protein as an alternative to iliac crest bone graft. Patients were radiographically evaluated at an average of 16.9 months postsurgery.


OBJECTIVE
To determine safety and efficacy of PLIF procedures using recombinant human bone morphogenic protein type 2 (rhBMP-2) and an absorbable collagen sponge carrier as an alternative for iliac crest bone graft.


BACKGROUND
Studies have shown that rhBMP-2 is safe and effective in anterior interbody and posterolateral lumbar spinal fusions to promote osteoinduction.


METHODS
Consecutive series of 48 patients who underwent PLIF procedures at a total of 59 operative levels, without autologous bone grafting, were evaluated preoperatively and at a minimum of 11.2 months postoperatively (maximum 23.8 mo). Radiographic assessment was conducted with thin-slice computed tomography reconstructions to assess for fusion. Clinical measures including Oswestry Disability Questionnaire were also used.


RESULTS
All patients demonstrated successful interbody and posterolateral fusions at all levels as determined by computed tomography scans. No patients demonstrated canal compromise, heterotopic bone formation, or adjacent level fusion.


CONCLUSIONS
PLIF using rhBMP-2 is a promising method for facilitating lumbar arthrodesis while eliminating the need for iliac crest bone graft harvesting.
Geibel
Paul T
PT
Department of Orthopaedics, University of Texas Health Science Center, San Antonio, TX, USA. pgeibel@spinaldoc.com
Boyd
Daniel L
DL
Slabisak
Vudhi
V
D000328:Adult; D000368:Aged; D055395:Bone Morphogenetic Protein 1 / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects / Q000502:physiology; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation; D016268:Internal Fixators / Q000592:standards; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D011994:Recombinant Proteins; C525705:BMP1 protein, human; D055395:Bone Morphogenetic Protein 1