Department of Spinal Surgery, Ganzhou People's Hospital, No. 16 Meiguan Avenue, Zhanggong District, Ganzhou City, Jiangxi Province, 341000, China.
BMC Surg. 2024 Nov 26;24(1):376. doi: 10.1186/s12893-024-02674-y.
To investigate the application of recombinant human bone morphogenetic protein-2 (RhBMP-2) in Percutaneous Endoscopic Posterior Lumbar Interbody Fusion (PE-PLIF).
The study randomly included 102 patients with lumbar spondylosis who underwent PE-PLIF at our hospital from April 2020 to August 2022. Following the random number table method, these subjects were graded as a study group of 51 cases and a control group of 51 cases. Posterior pedicle screw fixation treatment with RhBMP-2 or autologous bone was given respectively. The surgical status and perioperative complications, as well as lumbar spine function before surgery and at 1 and 12 months after surgery [Prolo score and Japanese Orthopaedic Association (JOA) score] of patients in the two groups were observed, and the postoperative fusion rate and cage displacement rate at 1 and 12 months after surgery were compared between the two groups. The degree of vertebral body slippage, intervertebral space height, and changes in quality of life were compared between the two groups before and 12 months after surgery.
There was no significant difference in hospital stay, surgical time, bleeding volume, and incidence of complications between the two groups (P > 0.05)0.12 months post-operation, the Prolo and JOA scores of both groups largely increased, which were significantly higher in the RhBMP-2 group than the control (P < 0.05). 12 months post-operation, the fusion rate in the RhBMP-2 group was 86.27%, which was significantly higher than that of 54.90% in the control group (P < 0.05). 12 months post-operation, the Cage displacement rate in the RhBMP-2 group was 5.88%, which was lower than that of 21.57% in the control group (P < 0.05). 12 months post-operation, the height of the intervertebral space in both groups largely increased, which was significantly higher in the RhBMP-2 group than in the control (P < 0.05). The degree of vertebral body slippage was significantly reduced in both groups, and the RhBMP-2 group was significantly lower than the control (P < 0.05). The cognitive function, social function, physiological function, and mental health were evidently improved in both groups 12 months post-operation and were significantly higher in the RhBMP-2 group than in the control (P < 0.05).
RhBMP-2 material in PE-PLIF could significantly restore lumbar function, promote postoperative fusion, reduce Cage displacement and vertebral slippage, accelerate recovery of lumbar intervertebral space, and improve patient quality of life.
探讨重组人骨形态发生蛋白-2(rhBMP-2)在经皮内镜后路腰椎椎间融合术(PE-PLIF)中的应用。
本研究采用随机数字表法将我院 2020 年 4 月至 2022 年 8 月收治的 102 例腰椎间盘突出症患者分为研究组(n=51)和对照组(n=51)。两组患者分别给予 rhBMP-2 或自体骨后路椎弓根螺钉固定治疗。观察两组患者的手术情况及围术期并发症,以及术前及术后 1、12 个月的腰椎功能[Prolo 评分和日本骨科协会(JOA)评分],比较两组患者术后 1、12 个月的融合率和椎间融合器移位率,比较两组患者术前和术后 12 个月的椎体滑脱程度、椎间隙高度和生活质量变化情况。
两组患者的住院时间、手术时间、出血量和并发症发生率比较差异均无统计学意义(P>0.05)。术后 0.12 个月,两组患者的 Prolo 和 JOA 评分均明显升高,且研究组均明显高于对照组(P<0.05)。术后 12 个月,研究组的融合率为 86.27%,明显高于对照组的 54.90%(P<0.05)。术后 12 个月,研究组的椎间融合器移位率为 5.88%,明显低于对照组的 21.57%(P<0.05)。术后 12 个月,两组患者的椎间隙高度均明显升高,且研究组明显高于对照组(P<0.05)。两组患者的椎体滑脱程度均明显降低,且研究组明显低于对照组(P<0.05)。术后 12 个月,两组患者的认知功能、社会功能、生理功能和心理健康评分均明显升高,且研究组均明显高于对照组(P<0.05)。
PE-PLIF 中使用 rhBMP-2 材料可显著恢复腰椎功能,促进术后融合,减少椎间融合器移位和椎体滑脱,加速腰椎椎间隙恢复,改善患者生活质量。