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Strut allograft union and remodeling using rhBMP-2 in a spinal corpectomy model
Klane K White1, Maneesh Bawa, Jae-Sung Ahn
1Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA.
Spine
|June 17, 2005
Summary
Recombinant human bone morphogenetic protein-2 (rhBMP-2) showed comparable fusion strength to autograft in bovine spinal models. This growth factor offers a promising alternative to autograft for lumbar corpectomy reconstruction.
Area of Science:
- Spinal surgery
- Orthopedic research
- Bone regeneration
Background:
- Autogenous strut grafts are standard for corpectomy fusion but cause donor site morbidity.
- Bone morphogenetic protein (BMP) augmentation shows promise for fusion, potentially reducing donor site issues.
Purpose of the Study:
- To compare recombinant human bone morphogenetic protein-2 (rhBMP-2) augmentation with autograft for cortical strut allograft incorporation after lumbar corpectomy.
- To evaluate the efficacy of rhBMP-2 as a bone graft substitute in spinal fusion.
Main Methods:
- Cortical strut allografts were used in a bovine spinal model following L3 corpectomy.
- Allografts were augmented with either rhBMP-2 in a collagen sponge or local autogenous bone.
- Evaluations included radiographic, biomechanical, and histologic analysis after 4 months.
Main Results:
- Allograft fusion occurred in most specimens in both groups (7/8 autograft, 8/8 rhBMP-2).
- rhBMP-2 group showed denser bone at allograft ends, while autograft had more uniform bone distribution.
- Histology confirmed allograft remodeling and incorporation; biomechanical tests showed no significant difference in fusion strength.
Conclusions:
- rhBMP-2 supplemented allografts demonstrated comparable incorporation and fusion strength to autograft-enhanced allografts.
- rhBMP-2 represents a viable alternative to autograft for enhancing cortical strut allografts in lumbar corpectomy procedures.