Comparison of rhBMP-2 versus Autogenous Iliac Crest Bone Graft for 2-Level Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy

Med Sci Monit. 2015 Oct 19:21:3159-65. doi: 10.12659/msm.894656.

Abstract

Background: Few studies have examined the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) in 2-level anterior cervical discectomy and fusion (ACDF). The purpose of this study was to compare the outcomes in a series of patients with CSM treated with 2-level ACDF with or without rhBMP-2.

Material and methods: The retrospective study included a total of 146 patients with CSM. The rhBMP-2 group consisted of 73 patients who underwent 2-level ACDF with rhBMP-2. A total of 73 patients who also received 2-level ACDF with autogenous ICBG alone were included in the matched-pair ICBG group with a ratio of 1:1, based on age, sex, and BMI. All data, including fusion rate and time, VAS, JOA score, operative date, and complications, were assessed.

Results: With respect to the length of hospital stay, operative times, and blood loss, there were no significant difference between the 2 groups. However, the rhBMP-2 group presented a shorter fusion time (P<0.013) and higher fusion rate (P<0.036) than the ICBG group. In the rhBMP-2 group, 22% required additional treatment for complications compared to 18% of patients in the ICBG group, which showed no significant difference (P=0.543).

Conclusions: The application of rhBMP-2 in 2-level ACDF showed higher fusion rates, shorter fusion time, and similar function outcomes compared to those who received ACDF with ICBG alone.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Bone Morphogenetic Protein 2 / therapeutic use*
  • Bone Transplantation / methods*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Diskectomy / methods*
  • Female
  • Humans
  • Ilium / pathology*
  • Length of Stay
  • Male
  • Middle Aged
  • Radiography
  • Recombinant Proteins / therapeutic use
  • Retrospective Studies
  • Smoking
  • Spinal Cord Diseases / therapy*
  • Spinal Fusion / methods*
  • Transforming Growth Factor beta / therapeutic use*
  • Treatment Outcome

Substances

  • Bone Morphogenetic Protein 2
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • recombinant human bone morphogenetic protein-2