Hsu Wellington K, Wang Jeffrey C
Department of Orthopedic Surgery, and Rehabilitation, University of Wisconsin Madison, USA.
Spine J. 2008 May-Jun;8(3):419-25. doi: 10.1016/j.spinee.2008.01.008. Epub 2008 Apr 2.
Because pseudarthrosis remains a clinically significant complication after spinal arthrodesis, the role of recombinant bone morphogenetic proteins (BMPs) is continually evaluated in spine surgery.
This article reviews the important literature in clinical research involving the use of BMPs in the augmentation of spinal fusion.
STUDY DESIGN/SETTING: Review article.
A literature search was performed via MEDLINE through PubMed with the dates January 1960 to July 2007 using the keywords "bone morphogenetic protein, BMP, spinal arthrodesis, and/or bone healing." Pertinent preclinical and clinical publications were chosen based on relevance and quality for inclusion in this study.
Publications focused on the historical context and potential clinical applications using BMP were selected to delineate the risks, benefits, and current indications for the augmentation of spinal arthrodesis.
Although multiple commercially available recombinant BMPs have demonstrated clinical success in interbody and posterolateral fusions, the associated costs preclude its routine use in spinal arthrodesis. The spine surgeon must assess each patient individually based on age, bone quality, diagnosis, comorbidities, and risks of nonunion to determine the cost effectiveness of the use of BMP to augment spinal fusion.
由于脊柱融合术后假关节仍然是一种具有临床意义的并发症，重组骨形态发生蛋白（BMP）在脊柱手术中的作用不断得到评估。
本文回顾了有关使用BMP增强脊柱融合的临床研究的重要文献。
研究设计/场所：综述文章。
通过MEDLINE在PubMed上进行文献检索，检索时间为1960年1月至2007年7月，关键词为“骨形态发生蛋白、BMP、脊柱融合术和/或骨愈合”。根据相关性和质量选择相关的临床前和临床出版物纳入本研究。
选择了关注使用BMP的历史背景和潜在临床应用的出版物，以描述增强脊柱融合术的风险、益处和当前适应症。
尽管多种市售重组BMP已在椎间融合和后外侧融合中显示出临床成功，但相关成本使其无法在脊柱融合术中常规使用。脊柱外科医生必须根据患者的年龄、骨质、诊断、合并症和不愈合风险对每个患者进行单独评估，以确定使用BMP增强脊柱融合术的成本效益。
