Oliveira Oberdan Ribeiro Gonçalves de, Martins Saul Pinheiro Rebouças, Lima Wyvison Gomes de, Gomes Marília Maia
Hospital Dom Hélder Câmara, Departamento de Cirurgia Ortopédica, Recife, PE, Brazil.
Rev Bras Ortop. 2016 Jun 22;52(2):124-140. doi: 10.1016/j.rboe.2016.03.005. eCollection 2017 Mar-Apr.
Bone morphogenetic proteins (BMP) are multi-functional growth factors to promote bone healing with the proposal of less morbidity compared to the usual methods of bone graft harvest. Pseudoarthrosis occur when the fusion attempt fails, a solid fusion is not achieved, or there is motion across the segment leading to it, and it can be clinically symptomatic as pain, deformity, neurocompression, or hardware failure. BMPs are used at spinal fusion as a tool for the treatment of degenerative, traumatic, neoplastic and infectious conditions of the spine. This review shows that the use of BMPS is effective and secure when compared with iliac crest bone graft (ICGB); however, depending of the location of usage (cervical spine, lumbar spine or sacrum) and the medical status of the patient (presence of comorbidities, tobacco usage), it is more likely to exhibit complications. Therefore, the use of these proteins must be an informed decision of patient and physician preferences.
骨形态发生蛋白(BMP)是多功能生长因子,与常规骨移植方法相比,其促进骨愈合的发病率更低。当融合尝试失败、未实现牢固融合或该节段存在导致假关节的活动时,就会发生假关节,临床上可能表现为疼痛、畸形、神经受压或内固定失败等症状。BMP在脊柱融合术中用作治疗脊柱退行性、创伤性、肿瘤性和感染性疾病的工具。这篇综述表明,与髂嵴骨移植(ICGB)相比,使用BMP是有效且安全的;然而,根据使用部位(颈椎、腰椎或骶骨)和患者的医疗状况(合并症的存在、吸烟情况),其更有可能出现并发症。因此,使用这些蛋白质必须是患者和医生基于偏好做出的明智决定。