Effective doses of recombinant human bone morphogenetic protein-2 in experimental spinal fusion.
Spine (Phila Pa 1976)
; 21(18): 2115-22, 1996 Sep 15.
Article
em En
| MEDLINE
| ID: mdl-8893436
ABSTRACT
STUDY DESIGN:
Nineteen dogs underwent L4-L5 intertransverse process fusions with either 58 micrograms, 115 micrograms, 230 micrograms, 460 micrograms, or 920 micrograms of recombinant human bone morphogenetic protein-2 carried by a polylactic acid polymer. A previous study (12 dogs) compared 2300 micrograms of recombinant human bone morphogenetic protein-2, autogenous iliac bone, and carrier alone in this model. All fusions subsequently were compared.OBJECTIVES:
To characterize the dose-response relationship of recombinant human bone morphogenetic protein-2 in a spinal fusion model. SUMMARY OF BACKGROUND DATA Recombinant osteoinductive morphogens, such as recombinant human bone morphogenetic protein-2, are effective in vertebrate diaphyseal defect and spinal fusion models. It is hypothesized that the quality of spinal fusion produced with recombinant human bone morphogenetic protein-2, above a threshold dose, does not change with increasing amounts of inductive protein.METHODS:
After decortication of the posterior elements, the designated implants were placed along the intertransverse process space bilaterally. The fusion sites were evaluated after 3 months by computed tomography imaging, high-resolution radiography, manual testing, mechanical testing, and histologic analysis.RESULTS:
As in the study using 2300 micrograms of recombinant human bone morphogenetic protein-2, implantation of 58-920 micrograms of recombinant human bone morphogenetic protein-2 successfully resulted in intertransverse process fusion in the dog by 3 months. This had not occurred in animals containing autograft or carrier alone. The cross-sectional area of the fusion mass and mechanical stiffness of the L4-L5 intersegment were not dose-dependent. Histologic findings varied but were not related to rhBMP-2 dose. Inflammatory reaction to the composite implant was proportional inversely to the volume of the fusion mass.CONCLUSIONS:
No mechanical, radiographic, or histologic differences in the quality of intertransverse process fusion resulted from a 40-fold variation in dose of recombinant human bone morphogenetic protein-2.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fusão Vertebral
/
Proteínas Recombinantes
/
Fator de Crescimento Transformador beta
/
Proteínas Morfogenéticas Ósseas
/
Vértebras Lombares
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Animals
Idioma:
En
Revista:
Spine (Phila Pa 1976)
Ano de publicação:
1996
Tipo de documento:
Article
País de afiliação:
Estados Unidos