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19 October 2015 : Clinical Research  

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

Bingyi TanACEF, Haiyan WangBC, Jun DongDE, Zenong YuanBD, Dachuan WangCD, Feng WangBD

DOI: 10.12659/MSM.894656

Med Sci Monit 2015; 21:3159-3165

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.

Keywords: Bone Morphogenetic Protein 2 - therapeutic use, Bone Transplantation - methods, Cervical Vertebrae - radiography, Diskectomy - methods, Ilium - pathology, Length of Stay, Recombinant Proteins - therapeutic use, Smoking, Spinal Cord Diseases - therapy, Transforming Growth Factor beta - therapeutic use

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750