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Effect analysis of bone morphogenetic protein-2 on lumbar interbody fusion |
ZHENWan-yuan YAN Yan-xiang XIONG Chang-jun WANGGuan-qing WU Rui |
Department of Orthopedics,Wuhan 672 Hospital of Integrated TCM and Western Medicine in Hubei Province,Wuhan 430079,China |
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Abstract ObjectiveTo observe the therapeutic effect of BMP-2 on lumbar interbody fusion.Methods106 patients with lumbar degenerative disease in Department of Orthopedics of our hospital form July 2011 to January 2016 were selected and divided into BMP-2 interbody fusion group (the bone repairmaterial of BMP-2 were filled in Cage,n=57) and traditional fusion group(autogenous boneswere filled in Cage,n=49)according to the differentways of repair.Average time during the operation and average intraoperative blood losswere compared between two groups,the rate of screw malposition and Cage shift loss and value of relative intervertebral height loss after operation for the firstweek,4th,6th,8th, 12th,24thweek,ODIand JOA before operation and after operation for the 24thweek and radiographic results were compared between two groups.ResultsAverage time during the operation and average intraoperative blood losswere no signiflcant difference between two groups (P>0.05).After the firstweek of operation,the rate of screw malposition in traditional fusion group was 1.53%and without screw malposition in BMP-2 interbody fusion group;after operation for the 24thweek,the rate of screw malposition in traditional fusion group was 15.30%and 3.51%in BMP-2 interbody fusion group,and the difference between two groups was statistically significant(P<0.05).The rate of Cage shift in traditional fusion group was 4.08%after operation for the 4thweek and without Cage shift in BMP-2 interbody fusion group;one Cage (1.75%)shifted in BMP-2 interbody fusion group until the 6thweek of postoperation;after operation for the 24thweek,the rate of Cage shift in traditional fusion group and BMP-2 interbody fusion group was respectively 20.41%and 7.02%,there was significant difference between two groups(P<0.05).Relative intervertebral height in the traditional fu-sion group and BMP-2 interbody fusion group was(2.11±0.40)mm and(0.52±0.60)mm,and the difference was statistically significant (P<0.05).The preoperative ODI score and JOA score in traditional fusion group was respectively (40.55±10.35)scores,(13.03±3.45)scores,and(39.32±9.63)scores,(14.56±2.17)scores in BMP-2 interbody fusion group, while after operation for the 24thweek,ODIscore and JOA score in the two groups was respectively (17.2±8.4)scores, (22.01±3.41)scores and (7.5±3.3)scores,(28.42±1.22)scores,therewas statistical difference (P<0.05).ConclusionThe lumbar interbody fusion surgery using BMP-2 bone repairmaterials which replaces autologous bone not only can provide immediate biological stability,achieve effective structural support,but also can promote the recovery intervertebral disc height of patients and obviously improve the patient′spain symptoms.
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[1] |
董荣鹏,赵建武.腰椎退变性疾病的治疗进展[J].实用心脑肺血管病杂志,2012,20(6):948-950.
|
[2] |
徐奎,覃正仕,赵权.腰椎间盘突出症微创治疗研究进展[J].现代中西医结合杂志,2016,25(1):109-112.
|
[3] |
梁小龙,杨学军,邢文华,等.腰椎间盘突出症外科治疗进展[J].内蒙古医学杂志,2016,48(4):75-81.
|
[4] |
王以朋.腰椎退变性疾病固定融合的选择[J].中华医学杂志,2006,86(25):1731-1733.
|
[5] |
郝剑,郝钊.骨移植材料研究进展[J].中国中西医结合外科杂志,2016,22(1):92-94.
|
[6] |
ten Dijke P,Bonemorphogenetic protein signal transduction in bone[J].Curr Med Res Opin,2006,22(Suppl 1):S7-S11.
|
[7] |
Wang C,Wang J,Li J,et al.KDM5A controls bone morphogenic protein 2-induced osteogenic differentiation of bone mesenchymal stem cells during osteoporosis[J].Cell Death Dis,2016,7(8):e23-e35.
|
[8] |
Samartzis D,Shen FH,Matthews DK,et al.Comparison of allograft to autograft inmultilevel anterior cervical discectomy and fusion with rigid plate fixation[J].Spine J,2003,3(6):451-459.
|
[9] |
Zigler JE,Delamarter RB.Oswestry disability index[J].J Neurosurg Spine,2014,20(2):241-242.
|
[10] |
孙翊夫,康明阳,候婷婷,等.BMP-2和VEGF在大鼠骨缺损修复过程中的表达和意义[J].临床和实验医学杂志,2014,13(6):432-435.
|
[11] |
刘久翔,王青,范卫民,等.自体骨软骨移植术治疗膝关节软骨损伤的临床疗效[J].江苏医药,2016,42(7):830-832.
|
[12] |
张志宏,刘志礼,高志增,等.骨修复替代材料修复骨缺损的选择与应用[J].中国组织工程研究,2012,16(52):9836-9843.
|
[13] |
徐建民,王兆朋,王恒孝.骨形态发生蛋白-2在兔骨折愈合过程中的作用[J].中国矫形外科杂志,2016,24(10):920-925.
|
[14] |
Vural AC,Odabas S,Korkusuz P,et al.Cranial bone regeneration via BMP-2 encoding mesenchymal stem cells[J]. Artif Cells Nanomed Biotechnol,2016,22:1-7.
|
[15] |
Yun PY,Kim YK,Jeong KI,et al.Influence of bone morphogenetic protein and proportion of hydroxyapatite on new bone formation in biphasic calcium phosphate graft:two pilot studies in animal bony defectmodel[J].JCraniomaxillofac Surg,2014,42(8):1909-1917.
|
[16] |
Lee JH,Baek HR,Lee KM,et al.Enhanced osteoinductivity of recombinant human bone morphogenetic protein-2 in combination with epidermal growth factor in a rabbit tibial defectmodel[J].Growth Factors,2015,33(1):31-39.
|
|
|
|