Effect of Mixture of Recombinant Human Bone Morphogenic Protein-2 and demineralized Bone Matrix in Lateral Lumbar Interbody Fusionopen access
- Authors
- Son, Jun Ik; Lee, Young-Seok; Ko, Myeong Jin; Wui, Seong Hyun; Park, Seung Won
- Issue Date
- May-2024
- Publisher
- 대한신경외과학회
- Keywords
- Bone morphogenetic protein 2; Demineralized bone matrix; Spinal fusion
- Citation
- Journal of Korean Neurosurgical Society, v.67, no.3, pp 354 - 363
- Pages
- 10
- Journal Title
- Journal of Korean Neurosurgical Society
- Volume
- 67
- Number
- 3
- Start Page
- 354
- End Page
- 363
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/73240
- DOI
- 10.3340/jkns.2023.0136
- ISSN
- 2005-3711
1598-7876
- Abstract
- This study aims to determine the optimal dose of recombinant-human Bone Morphogenic Protein-2 (rhBMP-2) for successful bone fusion in minimally invasive Lateral Lumbar Interbody Fusion (MIS LLIF). Previous studies show that rh-BMP is an effective alternative to autologous iliac crest bone graft, but the optimal dose remains uncertain. The study analyzes the fusion rates associated with different rh-BMP doses to provide a recommendation for the optimal dose in MIS LLIF. 93 patients underwent MIS LLIF using demineralized bone matrix (DBM) or a mixture of rhBMP-2 and DBM as fusion material. The group was divided into the following three groups according to the rhBMP-2 usage. Group A (only DBM was used, n: 27). Group B (1mg of rhBMP-2 per 5cc of DBM paste, n: 41). Group C (2mg of rhBMP-2 per 5cc of DBM paste, n: 25). Demographic data, clinical outcomes, postoperative complication and fusion were assessed. At 12 months post-surgery, the overall fusion rate was 92.3% according to Bridwell fusion grading system. Group B and C, who received rhBMP-2, had significantly higher fusion rates than group A, who received only DBM. However, there was no significant increase in fusion rate when the rhBMP-2 dosage was increased from group B to group C. The group B and C showed significant improvement in back pain and ODI compared to the group A. The incidence of screw loosening was decreased in group B and C, but there was no significant difference in the occurrence of other complications. Usage of rhBMP-2 in LLIF surgery leads to early and increased final fusion rates, which can result in faster pain relief and return to daily activities for patients. The benefits of using rhBMP-2 were not significantly different between the groups that received 1mg/5cc and 2mg/5cc of rhBMP-2. Therefore, it is recommended to use 1mg of rhBMP-2 with 5cc of DBM, taking both economic and clinical aspects into consideration.
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