J Minim Invasive Spine Surg Tech.  2021 Apr;6(1):2-8. 10.21182/jmisst.2021.00094.

Lumbar Interbody Fusion using Low-dose of Recombinant Human Bone Morphogenetic Protein-2 (rh-BMP2); Minimum 1-year Follow-up Results at A Single Institute

• Choi Ss
• Lim WJ
• Lee MK
• Ryu KS

• KMID: 2562075
• DOI: http://doi.org/10.21182/jmisst.2021.00094

Abstract

Objective
The authors evaluate clinical results of the lumbar interbody fusion surgery using low-dose of recombinant human bone morphogenetic protein type 2(rhBMP-2) to assess the safety and efficacy of rhBMP-2.
Methods
199 patients who underwent lumbar interbody fusion surgery including posterior lumbar interbody fusion (PLIF) and oblique interbody fusion (OLIF) using rhBMP-2 (0.05 mg per disc) were selected. Fusion status at the operated segment was classified from grade 1 to 4, according follow-up CT scan. The occurrence of complications was observed including heterotopic ossification, postoperative radiculitis, and endplate osteolysis.
Results
There were 61 men and 138 women. Total surgical levels were 424 levels. According to the surgical method, 335 segments were operated with the PLIF and 89 segments with the OLIF. On follow up CT scan, fusion grade was distributed as 330 levels of grade 1 (77.8%), 66 of grade 2 (15.6%), 22 of grade 3 (5.2%), and 6 of grade 4 (1.4%). Overall fusion success rate was found to be 93.4%. According to fusion method, in PLIF group, it was distributed as 267 levels of grade 1 (79.7%), 45 of grade 2 (13.4%), 18 of grade 3 (5.4%), and 5 of grade 4 (1.5%), and in OLIF group, 63 levels of grade 1 (70.8%), 21 of grade 2 (23.6%), 4 of grade 3 (4.5%), and 1 of grade 4 (1.1%). No patient was suspected of having postoperative radiculitis related to the use of rh-BMP2. Two case showed ectopic bone formation without clinical symptom. There were 2 cases of endplate osteolysis.
Conclusion
The known complications is not common in the present study, which may be caused by using low-dose rhBMP-2. Further long term observations are needed to clarify these issues of such complications.

Keyword

Lumbar; Interbody fusion; Bone morphogenic protein