Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion.

Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Research Abstract Details 

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Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Abstract Text:

Harvinder S Sandhu,Jeffrey M Toth,Ashish D Diwan,H B Seim,Linda E A Kanim,J Michael Kabo,A Simon Turner,

STUDY DESIGN: The sheep anterior lumbar spinal fusion model was used to study the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2)-collagen composite in comparison with autograft to enhance spinal interbody fusion. Comparisons were drawn from temporal radiographic and end-point biomechanical and histologic data. OBJECTIVE: To analyze histologically the ability of rhBMP-2 to achieve complete arthrodesis between vertebral bodies. SUMMARY OF BACKGROUND DATA: Studies using rhBMP for enhancement of anterior interbody fusion have used numerous endpoints. However, systematic histologic evaluation of the fusion has not been conducted. METHODS: Twelve sheep underwent single-level anterior lumbar interbody fusion performed with a cylindrical fenestrated titanium interbody fusion device (INTER FIX, Medtronic Sofamor Danek, Inc., Memphis, TN). The device was filled either with rhBMP-2-collagen (n = 6) or autogenous iliac crest bone graft (n = 6). Radiologic evaluation was carried out at 2-month intervals, and all sheep were killed 6 months after surgery. Nondestructive biomechanical testing for stiffness to flexion, extension, and lateral bending moments, un-decalcified histology, and qualitative and quantitative histologic evaluation were performed. RESULTS: Radiographs revealed a bony bridge anterior to the cage in five of six rhBMP-2-treated animals, whereas it was present only in one of five in the autogenous bone graft group. Segments treated with rhBMP-2 were 20% stiffer in flexion than autograft-treated segments at 6 months. Six of six in the rhBMP-2 group and two of six in the autograft group showed complete fusion. There was a significantly higher rate of bony continuity observed at the fenestrations of the rhBMP-2 group. Three times more number of cage fenestrations in the rhBMP-2 group demonstrated "all-bone" when compared with the autograft group (P < 0.001). Further, the scar tissue in and around the autograft-treated cages was 16-fold more (P < 0.01) than that seen for rhBMP-2-treated cages. CONCLUSIONS: The study demonstrates that rhBMP-2 can lead to earlier radiologic fusion and a more consistent increased stiffness of the segments when compared with autograft in sheep anterior lumbar interbody fusion. Furthermore, a three times higher histologic fusion rate is attainable with significantly reduced fibrous tissue around the implant when rhBMP-2 is used.

Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Publishing Authors By Initials

HS Sandhu,JM Toth,AD Diwan,HB Seim,LE Kanim,JM Kabo,AS Turner,

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

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Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Spine

VOLUME: 27

Page Numbers: 567-75

Journal Abbreviation: Spine

ISSN: 1528-1159

DAY: 15

MONTH: Mar

YEAR: 2002

Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Information

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LANGUAGE: eng

NlmUniqueID: 7610646

Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: methods

Chemical & Substance for Abstract: Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion. Information

Substance Name: Titanium

Registry Number: 7440-32-6

Grant and Affiliation Information for Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion.

AFFILIATION: Department of Orthopaedic Surgery and UCLA Comprehensive Spine Center, UCLA School of Medicine, Los Angeles, California, USA.

Country: United States

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MEDLINETA: Spine

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