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Published in: International Orthopaedics 4/2009

01-08-2009 | Original Paper

Clinical and radiographic outcomes of posterolateral lumbar spine fusion in humans using recombinant human bone morphogenetic protein-2: an average five-year follow-up study

Authors: Yoshito Katayama, Yukihiro Matsuyama, Hisatake Yoshihara, Yoshihito Sakai, Hiroshi Nakamura, Shiro Imagama, Zenya Ito, Norimitsu Wakao, Mitsuhiro Kamiya, Yasutsugu Yukawa, Tokumi Kanemura, Koji Sato, Hisashi Iwata, Naoki Ishiguro

Published in: International Orthopaedics | Issue 4/2009

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Abstract

The objectives of this study were to determine whether recombinant human bone morphogenetic protein-2 (rhBMP-2) can be used as the sole stimulator of osteogenesis with success equal to an autologous graft in posterolateral lumbar fusion (PLF) at the same level and to describe the progress until bone union. This study included 11 patients who underwent PLF of L4-5. On the right side, only rhBMP-2, for which polylactic/glycolic acid (PLGA) was used as a carrier, was used, whereas, on the left side, autogenous bone was used. The bone union rate was 73 and 82% at 12 and 24 months after surgery, respectively, on the right BMP side, while the rate on the autogenous bone side was 91%. There was no statistically significant difference in the bone union rate. rhBMP-2 can be used as the sole source of osteogenesis with success equivalent to an autologous graft of the PLF.
Literature
1.
go back to reference Arrington ED, Smith WJ, Chambers HG et al (1996) Complications of iliac crest bone graft harvesting. Clin Orthop 329:300–309PubMedCrossRef Arrington ED, Smith WJ, Chambers HG et al (1996) Complications of iliac crest bone graft harvesting. Clin Orthop 329:300–309PubMedCrossRef
2.
go back to reference Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 20:1055–1060PubMedCrossRef Banwart JC, Asher MA, Hassanein RS (1995) Iliac crest bone graft harvest donor site morbidity. A statistical evaluation. Spine 20:1055–1060PubMedCrossRef
3.
go back to reference Boden SD (2000) Biology of lumbar spine fusion and use of bone graft substitutes: present, future, and next generation. Tissue Eng 6:383–399PubMedCrossRef Boden SD (2000) Biology of lumbar spine fusion and use of bone graft substitutes: present, future, and next generation. Tissue Eng 6:383–399PubMedCrossRef
4.
go back to reference Boden SD, Zdeblick TA, Sandhu HS, Heim SC (2000) The use of rhBMP-2 in interbody fusion cages. Definitive evidence of osteoinduction in humans: a preliminary report. Spine 25:376–381PubMedCrossRef Boden SD, Zdeblick TA, Sandhu HS, Heim SC (2000) The use of rhBMP-2 in interbody fusion cages. Definitive evidence of osteoinduction in humans: a preliminary report. Spine 25:376–381PubMedCrossRef
5.
go back to reference Boden SD, Kang J, Sandhu HS, Heller JG (2002) Use of recombinant bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective randomized clinical pilot trial: 2002 Volvo Award in clinical studies. Spine 27:2662–2673PubMedCrossRef Boden SD, Kang J, Sandhu HS, Heller JG (2002) Use of recombinant bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective randomized clinical pilot trial: 2002 Volvo Award in clinical studies. Spine 27:2662–2673PubMedCrossRef
6.
go back to reference Fischgrund JS, Mackay M, Herkowitz HN et al (1997) 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine 22:2807–2812PubMedCrossRef Fischgrund JS, Mackay M, Herkowitz HN et al (1997) 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine 22:2807–2812PubMedCrossRef
7.
go back to reference Fischgrund JS, James SB, Chabot MS et al (1997) Augmentation of autograft using rhBMP-2 and different carrier media in the canine spine fusion model. J Spinal Disord 10:467–472PubMedCrossRef Fischgrund JS, James SB, Chabot MS et al (1997) Augmentation of autograft using rhBMP-2 and different carrier media in the canine spine fusion model. J Spinal Disord 10:467–472PubMedCrossRef
8.
go back to reference Glassman SD, Dimar JR, Carreon LY et al (2005) Initial fusion rates with recombinant human bone morphogenetic protein-2/compression resistant matrix and a hydroxyapatite and tricalcium phosphate/collagen carrier in posterolateral spinal fusion. Spine 30:1694–1698PubMedCrossRef Glassman SD, Dimar JR, Carreon LY et al (2005) Initial fusion rates with recombinant human bone morphogenetic protein-2/compression resistant matrix and a hydroxyapatite and tricalcium phosphate/collagen carrier in posterolateral spinal fusion. Spine 30:1694–1698PubMedCrossRef
9.
go back to reference Grauer JN, Patel TC, Erulkar JS et al (2000) Evaluation of OP-1 as a graft substitute for the intertransverse process lumbar fusion. Spine 6:127–133 Grauer JN, Patel TC, Erulkar JS et al (2000) Evaluation of OP-1 as a graft substitute for the intertransverse process lumbar fusion. Spine 6:127–133
10.
go back to reference Hadjipavlou AG, Simmons JW, Tzermiadianos MN et al (2001) Plaster of Paris as bone substitute in spinal surgery. Eur Spine J 10(Suppl 2):S189–S196PubMed Hadjipavlou AG, Simmons JW, Tzermiadianos MN et al (2001) Plaster of Paris as bone substitute in spinal surgery. Eur Spine J 10(Suppl 2):S189–S196PubMed
11.
go back to reference Herkowitz HN, Kurz LT (1991) Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am 73:802–808PubMed Herkowitz HN, Kurz LT (1991) Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am 73:802–808PubMed
12.
go back to reference Holliger EH, Trawick RH, Boden SD et al (1996) Morphology of the lumbar intertransverse process fusion mass in the rabbit model: a comparison between two bone graft materials—rhBMP-2 and autograft. J Spinal Disord 9:125–128PubMedCrossRef Holliger EH, Trawick RH, Boden SD et al (1996) Morphology of the lumbar intertransverse process fusion mass in the rabbit model: a comparison between two bone graft materials—rhBMP-2 and autograft. J Spinal Disord 9:125–128PubMedCrossRef
13.
go back to reference Li H, Zou X, Xue Q et al (2004) Anterior lumbar interbody fusion with carbon fiber cage loaded with bioceramics and platelet-rich plasma. An experimental study on pigs. Eur Spine J 13:354–358PubMedCrossRef Li H, Zou X, Xue Q et al (2004) Anterior lumbar interbody fusion with carbon fiber cage loaded with bioceramics and platelet-rich plasma. An experimental study on pigs. Eur Spine J 13:354–358PubMedCrossRef
14.
go back to reference Magin MN, Delling G (2001) Improved lumbar vertebral interbody fusion using rhOP-1: a comparison of autogenous bone graft, bovine hydroxylapatite (Bio-Oss), and BMP-7 (rhOP-1) in sheep. Spine 26:469–478PubMedCrossRef Magin MN, Delling G (2001) Improved lumbar vertebral interbody fusion using rhOP-1: a comparison of autogenous bone graft, bovine hydroxylapatite (Bio-Oss), and BMP-7 (rhOP-1) in sheep. Spine 26:469–478PubMedCrossRef
15.
go back to reference Martin GJ Jr, Boden SD, Marone MA, Moskovitz PA (1999) Posterolateral intertransverse process spinal arthrodesis with rhBMP-2 in a nonhuman primate: important lessons learned regarding dose, carrier, and safety. J Spinal Disord 12:179–186PubMed Martin GJ Jr, Boden SD, Marone MA, Moskovitz PA (1999) Posterolateral intertransverse process spinal arthrodesis with rhBMP-2 in a nonhuman primate: important lessons learned regarding dose, carrier, and safety. J Spinal Disord 12:179–186PubMed
16.
go back to reference McKay WF, Peckham SM, Badura JM (2007) A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE Bone Graft). Int Orthop 31:729–734PubMedCrossRef McKay WF, Peckham SM, Badura JM (2007) A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE Bone Graft). Int Orthop 31:729–734PubMedCrossRef
17.
go back to reference Sandhu HS, Kanim LE, Kabo JM et al (1996) Effective doses of recombinant human bone morphogenetic protein-2 in experimental spinal fusion. Spine 21:2115–2122PubMedCrossRef Sandhu HS, Kanim LE, Kabo JM et al (1996) Effective doses of recombinant human bone morphogenetic protein-2 in experimental spinal fusion. Spine 21:2115–2122PubMedCrossRef
18.
go back to reference Sandhu HS, Kanim LM, Toth JM et al (1997) Experimental spinal fusion with recombinant human bone morphogenetic protein-2, without decortication of osseous elements. Spine 22:1171–1180PubMedCrossRef Sandhu HS, Kanim LM, Toth JM et al (1997) Experimental spinal fusion with recombinant human bone morphogenetic protein-2, without decortication of osseous elements. Spine 22:1171–1180PubMedCrossRef
19.
go back to reference Schimandle JH, Boden SD, Hutton WC (1995) Experimental spinal fusion with recombinant human bone morphogenetic protein-2. Spine 20:1326–1337PubMedCrossRef Schimandle JH, Boden SD, Hutton WC (1995) Experimental spinal fusion with recombinant human bone morphogenetic protein-2. Spine 20:1326–1337PubMedCrossRef
20.
go back to reference Steinmam JC, Herkowitz HN (1992) Pseudarthrosis of the spine. Clin Orthop 284:80–90 Steinmam JC, Herkowitz HN (1992) Pseudarthrosis of the spine. Clin Orthop 284:80–90
21.
go back to reference Thalgott JS, Giuffre JM, Fritts K et al (2001) Instrumented posterolateral lumbar fusion using coralline hydroxyapatite with or without demineralized bone matrix, as an adjunct to autologous bone. Spine J 1:131–137PubMedCrossRef Thalgott JS, Giuffre JM, Fritts K et al (2001) Instrumented posterolateral lumbar fusion using coralline hydroxyapatite with or without demineralized bone matrix, as an adjunct to autologous bone. Spine J 1:131–137PubMedCrossRef
23.
go back to reference Vaccaro AR, Patel T, Fischgrund J et al (2003) A pilot safety and efficacy study of OP-1 putty (rhBMP-7) as an adjunct to iliac crest autograft in posterolateral lumbar fusions. Eur Spine J 12:495–500PubMedCrossRef Vaccaro AR, Patel T, Fischgrund J et al (2003) A pilot safety and efficacy study of OP-1 putty (rhBMP-7) as an adjunct to iliac crest autograft in posterolateral lumbar fusions. Eur Spine J 12:495–500PubMedCrossRef
24.
go back to reference Wozeney JM, Rosen V, Celeste AJ et al (1988) Novel regulators of bone formation: molecular clones and activities. Science 242:1528–1534CrossRef Wozeney JM, Rosen V, Celeste AJ et al (1988) Novel regulators of bone formation: molecular clones and activities. Science 242:1528–1534CrossRef
Metadata
Title
Clinical and radiographic outcomes of posterolateral lumbar spine fusion in humans using recombinant human bone morphogenetic protein-2: an average five-year follow-up study
Authors
Yoshito Katayama
Yukihiro Matsuyama
Hisatake Yoshihara
Yoshihito Sakai
Hiroshi Nakamura
Shiro Imagama
Zenya Ito
Norimitsu Wakao
Mitsuhiro Kamiya
Yasutsugu Yukawa
Tokumi Kanemura
Koji Sato
Hisashi Iwata
Naoki Ishiguro
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 4/2009
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-008-0600-5

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