Allograft plus OP-1 enhances ossification in posterolateral lumbar fusion: A seven year follow-up.
OBJECTIVE
To study the results of the combination of allograft plus BMP-7 in comparison with allograft alone in posterolateral lumbar arthrodesis.


METHODS
A blinded controlled consecutive prospective cohort of skeletally mature patients study. One hundred and ten patients underwent posterolateral lumbar instrumented arthrodesis. Allograft randomly compacted onto either the right or the left side of the articular and the posterior aspect of the transverse processes of lumbar spine. The same procedure performed on the contralateral side, but allograft was previously mixed with osteogenic protein (OP-1). Clinical, x-ray and CT-scan long follow-up performed. Univariable and multivariable logistic regression analyses.


RESULTS
More bone continuity was found with allograft plus OP-1 than with allograft alone (p>0.0038). The amount of bone mass was greater on the OP-1 side (p<0.001). No local or systemic adverse effect were noted.


CONCLUSIONS
Allograft on one side plus allograft with BMP-7 on the other achieved a fusion rate of 93 per cent. Allograft combined with BMP-7 was more effective than allograft alone.
Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Spain. Electronic address: eguerado@hcs.es.
Enrique
E
Guerado
Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Spain.
Ana M
AM
Cervan
Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Spain.
Maria L
ML
Bertrand
Department of Research, Statistic, and Epidemiology, Hospital Universitario Costa del Sol, University of Malaga, Spain.
Nicolas
N
Benitez-Parejo
D000328:Adult; D000368:Aged; D064591:Allografts; D001174:Arthrodesis / Q000379:methods; D055419:Bone Morphogenetic Protein 7 / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008161:Lumbosacral Region / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000187:drug effects*; D011446:Prospective Studies; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D018786:Bone Substitutes
Allograft; BMP; Fusion; Growth factors; Instrumentation; Lumbar spine; Spinal arthrodesis