Muschler G F, Hyodo A, Manning T, Kambic H, Easley K
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, OH 44195.
Clin Orthop Relat Res. 1994 Nov(308):229-40.
The efficacy of purified recombinant human bone morphogenetic protein-2 (rhBMP-2) delivered in a porous biodegradable copolymer, poly [D,L (lactide--coglycide)] (PLGA) was evaluated using a canine posterior segmental spinal fusion model. rhBMP-2/PLGA was compared to autogenous cancellous bone and to PLGA alone. Thirty three fusion sites in 11 beagle dogs were evaluated at 12 weeks for union and mechanical strength. Union score and mechanical testing showed no difference between autogenous cancellous bone and rhBMP-2/PLGA. Union scores for autogenous cancellous bone and rhBMP-2/PLGA sites were superior to those with PLGA alone (p = 0.001 and p = 0.0007, respectively). These findings suggest that synthetic bone graft substitute materials delivering purified rhBMP-2 may be suitable for posterior spinal fusions. The use of such materials may provide efficacy equivalent to autogenous cancellous bone and avoid the morbidity associated with the harvest of autogenous graft.
使用犬后段脊柱融合模型评估了在多孔可生物降解共聚物聚[D,L(丙交酯-共乙交酯)](PLGA)中递送的纯化重组人骨形态发生蛋白-2(rhBMP-2)的疗效。将rhBMP-2/PLGA与自体松质骨和单独的PLGA进行比较。在12周时评估了11只比格犬的33个融合部位的融合情况和机械强度。融合评分和机械测试表明自体松质骨和rhBMP-2/PLGA之间没有差异。自体松质骨和rhBMP-2/PLGA部位的融合评分优于单独使用PLGA的部位(分别为p = 0.001和p = 0.0007)。这些发现表明,递送纯化rhBMP-2的合成骨移植替代材料可能适用于后路脊柱融合。使用此类材料可能提供与自体松质骨相当的疗效,并避免与自体移植物采集相关的发病率。