Recombinant human bone morphogenetic protein-2 combined with autologous bone grafting and fusion in the treatment of thoracolumbar tuberculosis / 中国组织工程研究

ABSTRACT

BACKGROUND: The efficacy and safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with autologous bone grafting for the treatment of spinal degenerative diseases such as lumbar spondylolisthesis, spinal canal stenosis and intervertebral disc herniation have been recognized, but few clinical studies have been conducted on the efficacy and safety in the treatment of spinal infectious diseases such as spinal tuberculosis. OBJECTIVE: To evaluate the clinical efficacy and safety of rhBMP-2 combined with autologous bone grafting for spinal tuberculosis. METHODS: Clinical data of thoracolumbar tuberculosis admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from November 2010 to May 2018 were retrospectively analyzed. All patients underwent posterior pedicle screw fixation plus bone graft for spinal fusion, with (experimental group) or without (control group) the use of rhBMP-2. In the experimental group, 33 patients were treated with posterior pedicle fixation and autologous bone graft for spinal fusion combined with rhBMP-2 (1 mg). In the control group, 35 patients underwent posterior pedicle fixation and autologous bone graft. Visual analogue scale, the American Spinal Injury Association (ASIA), perioperative complications and fusion rate were statistically analyzed. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital, Guangzhou University of Chinese Medicine. Informed consent was obtained from each patient. RESULTS AND CONCLUSION: All patients were followed up for more than 1 year. During the follow-up period, no fracture or movement of the internal fixation or distinct collapse of the vertebral body were found. There was no significant difference between the two groups in terms of operative time, intraoperative blood loss, length of stay, and proportion of perioperative complications (P > 0.05). There was a significant improvement in visual analogue scale scores and ASIA grades in the two groups at 1 week and 1 year after operation (P 0.05). The fusion rate in the experimental group was significantly higher than that in the control group at 6 months after operation (P 0.05). These findings indicate that rhBMP-2 combined with autologous bone for the treatment of thoracolumbar tuberculosis can accelerate bone fusion with favorable efficacy and safety in a short time.