[Comparison of three different bone grafts for spinal fusion of degenerative lumbar disease].
OBJECTIVE
To compare the effectiveness of three different bone grafts [autogenous bone, allogeneic bone, and bone morphogenetic protein (BMP) composite bone] combined with screw system for spinal fusion of degenerative lumbar disease.


METHODS
Between January 2005 and January 2010, 102 cases of degenerative lumbar disease were randomly treated with autogenous bone (group A, n=35), allogeneic bone (group B, n=33), and BMP composite bone (group C, n=34). There was no significant difference in sex, age, disease duration, affected segments, Meyerding grade, preoperative intervertebral space height, and the Japanese Orthopaedic Association (JOA) score among 3 groups (P > 0.05). The intervertebral space height, bone fusion rate, and JOA score were compared among 3 groups at different time points.


RESULTS
All patients of 3 groups were followed up 2 to 5 years, with an average of 3.2 years. At 6 to 24 months after operation, the intervertebral space height significantly increased when compared with preoperative value in 3 groups (P < 0.05); the intervertebral space height of groups A and C was significantly greater than that of group B at 6, 12, 18, and 24 months after operation (P < 0.05), but no significant difference was found between groups A and C (P > 0.05). Bone graft fusion was observed at 6 months in groups A and C and at 12 months in group B; at 24 months, the rate of bone graft fusion was 100% in groups A and C, and 87.88% in group B, showing significant difference (P < 0.05). There was significant difference in JOA score between preoperation and postoperative 12th and 24th months (P < 0.05); at 12 and 24 months after operation, JOA socre and improving rate of groups A and C were significantly higher than those of group B (P < 0.05), but no significant difference was found between groups A and C (P > 0.05).


CONCLUSIONS
The effect of BMP composite bone is equivalent to that of autogenous bone graft in treating spinal fusion of degenerative lumbar disease, and they are better than allogeneic bone graft. BMP composite bone can obtain adequate bone grafts without invasive sampling, and has fast fusion and high successful rate.
Department of Orthopedics, Qingzhou Central Hospital Affiliated to Weifang Medical College, Qingzhou Shandong, PR China. scott626@163.com
Peng
P
Yin
Xiuzhen
X
Liu
Yanping
Y
Wu
Yinghua
Y
Sun
D000368:Aged; D001863:Bone Screws; D016025:Bone Transplantation; D003131:Combined Modality Therapy; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013123:Spinal Fusion; D013131:Spine; D016896:Treatment Outcome