Bone morphogenetic proteins in anterior lumbar interbody fusion: old techniques and new technologies. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004.

Abstract

The author reports the clinical and radiographic outcomes obtained in three prospective multicenter clinical trials in which recombinant human bone morphogenetic protein-2 (rhBMP-2) was used in anterior lumbar interbody fusion (ALIF). Stand-alone interbody fusion cages were used, and supplemental fixation was not performed as part of the study protocol. Patients were randomly assigned to one of two ALIF groups: one in which autologous iliac crest bone graft was used (control) and one in which an rhBMP-2-coated absorbable collagen sponge was placed (investigational group). In all patients who underwent rhBMP-2-augmented fusion, imaging demonstrated evidence of bone induction and early incorporation of the cortical allografts. Overall, more expedient clinical improvements and higher success rates were observed in the rhBMP-2 group. In these studies it was shown that rhBMP-2 is a safe and effective material for facilitating ALIF and for decreasing pain and improving clinical outcomes.