Skip to main content
Top
Published in: European Spine Journal 12/2008

01-12-2008 | Original Article

Posterior lumbar interbody fusion using rhBMP-2

Authors: Hans Jörg Meisel, Mark Schnöring, Christian Hohaus, Yvonne Minkus, Andre Beier, Timothy Ganey, Ulrich Mansmann

Published in: European Spine Journal | Issue 12/2008

Login to get access

Abstract

The use of biological technologies for the treatment of degenerative spinal diseases has undergone rapid clinical and scientific development. BMP strategies have gained wide support for an inherent potential to improve the ossification process. It has been extensively studied in combination with various techniques for spinal stabilisation from both anterior and posterior approach. We studied the fusion process after implantation of rhBMP-2 in 17 patients with degenerative lumbar spine diseases in combination with dorsal fixation with pedicle screws and poly-ether-ether-ketone (PEEK) interbody cages. We used 12 mg rhBMP-2 carried by collagen sponge, 6 mg in every cage. Patient follow up consisted of pre-operative radiographic and clinical evaluation. Similar post-operative evaluations were performed at 3 and 6 months. Clinical assessment demonstrated clear improvement in all patients despite evidence of vertebral endplate osteoclastic activity in the 3-month radiographs. The 6-month radiograph, however, confirmed evidence of fusion, and no untoward results or outcomes were noted. While previous studies have shown exclusively positive results in both fusion rates and process, our study demonstrated an intermediate morphology at 3 months during the ossification process using Induct Os in combination with peek-cages using a PLIF-technique. The transient resorption of bone surrounding the peek cage did not result in subsidence, pain or complication, and fusion was reached in all cases within a 6-month-controlled evaluation. Although there was no negative influence on clinical outcome, the potential for osteoclastic or metabolic resorption bears watching during the post-surgical follow up.
Literature
1.
go back to reference Boden SD, Burkus JK, Toth JM, Badura JM, McKay WF (2005) Osteoclastic response to rhBMP-2/absorbable collagen sponges (ACS) in a cancellous bone environment. NASS IRN 2749(066) Boden SD, Burkus JK, Toth JM, Badura JM, McKay WF (2005) Osteoclastic response to rhBMP-2/absorbable collagen sponges (ACS) in a cancellous bone environment. NASS IRN 2749(066)
2.
go back to reference Boden SD, Kangckha PJ, Sandhu H, Heller JG (2002) Use of recombinant human 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 27:2662–2673. doi:10.1097/00007632-200212010-00005 PubMedCrossRef Boden SD, Kangckha PJ, Sandhu H, Heller JG (2002) Use of recombinant human 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 27:2662–2673. doi:10.​1097/​00007632-200212010-00005 PubMedCrossRef
3.
go back to reference Burkus JK, Gornet MF, Dickman CA, Zdeblick TA (2002) Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages. J Spinal Disord Tech 15:337–349PubMed Burkus JK, Gornet MF, Dickman CA, Zdeblick TA (2002) Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages. J Spinal Disord Tech 15:337–349PubMed
4.
go back to reference Burkus JK, Heim SE, Gornet MF, Zdeblick TA (2003) Is INFUSE bone graft superior to autograft bone? An integrated analysis of clinical trials using the LT-CAGE lumbar tapered fusion device. J Spinal Disord Tech 16:113–122PubMed Burkus JK, Heim SE, Gornet MF, Zdeblick TA (2003) Is INFUSE bone graft superior to autograft bone? An integrated analysis of clinical trials using the LT-CAGE lumbar tapered fusion device. J Spinal Disord Tech 16:113–122PubMed
6.
go back to reference Cook DS, Rueger DC (2002) Preclinical models of recombinant BMP induced healing of orthopedic defects. In: Vukicevic S, Sampath KT (eds) Bone morphogenetic proteins from laboratory to clinical practice. Birkhauser Verlag, Basel, pp 121–145 Cook DS, Rueger DC (2002) Preclinical models of recombinant BMP induced healing of orthopedic defects. In: Vukicevic S, Sampath KT (eds) Bone morphogenetic proteins from laboratory to clinical practice. Birkhauser Verlag, Basel, pp 121–145
8.
go back to reference Janseen ME, Lam C, Beckham R (2001) Outcomes of allogenic cages in anterior and posterior lumbar interbody fusion. Eur Spine J 10(Suppl. 2):S158–S168. doi:10.1007/s005860100292 Janseen ME, Lam C, Beckham R (2001) Outcomes of allogenic cages in anterior and posterior lumbar interbody fusion. Eur Spine J 10(Suppl. 2):S158–S168. doi:10.​1007/​s005860100292
9.
go back to reference Johnsson R, Stromqvist B, Aspenberg P (2002) Randomized radiostereometric study comparing osteogenic protein-1 (BMP-7) and autograft bone in human noninstrumented posterolateral lumbar fusion: 2002 Volvo Award in clinical studies. Spine 27:2654–2661. doi:10.1097/00007632-200212010-00004 PubMedCrossRef Johnsson R, Stromqvist B, Aspenberg P (2002) Randomized radiostereometric study comparing osteogenic protein-1 (BMP-7) and autograft bone in human noninstrumented posterolateral lumbar fusion: 2002 Volvo Award in clinical studies. Spine 27:2654–2661. doi:10.​1097/​00007632-200212010-00004 PubMedCrossRef
10.
go back to reference Lanman TH, Hopkins TJ (2004) Lumbar interbody fusion after treatment with recombinant human bone morphogenetic protein-2 added to 70:30 poly (L-lactide-co-D, L-lactide) bioresorbable implant. Neurosurg Focus 16:3–9 Lanman TH, Hopkins TJ (2004) Lumbar interbody fusion after treatment with recombinant human bone morphogenetic protein-2 added to 70:30 poly (L-lactide-co-D, L-lactide) bioresorbable implant. Neurosurg Focus 16:3–9
14.
go back to reference Vaccaro AR, Patel T, Fishgrund J, Anderson G, Truumees E, Herkowitz HN et al (2004) A pilot study evaluating the safety and efficacy of OP-1 putty (rhBMP-7) as a replacement for iliac crest autograft in posterolateral lumbar arthrodesis for degenerative spondylolosthesis. Spine 29:1885–1892. doi:10.1097/01.brs.0000137062.79201.98 PubMedCrossRef Vaccaro AR, Patel T, Fishgrund J, Anderson G, Truumees E, Herkowitz HN et al (2004) A pilot study evaluating the safety and efficacy of OP-1 putty (rhBMP-7) as a replacement for iliac crest autograft in posterolateral lumbar arthrodesis for degenerative spondylolosthesis. Spine 29:1885–1892. doi:10.​1097/​01.​brs.​0000137062.​79201.​98 PubMedCrossRef
Metadata
Title
Posterior lumbar interbody fusion using rhBMP-2
Authors
Hans Jörg Meisel
Mark Schnöring
Christian Hohaus
Yvonne Minkus
Andre Beier
Timothy Ganey
Ulrich Mansmann
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 12/2008
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-008-0799-2

Other articles of this Issue 12/2008

European Spine Journal 12/2008 Go to the issue

Announcements

Announcements