Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/24566
Title: How does recombinant human bone morphogenetic protein-4 enhance posterior spinal fusion?
Authors: Cheng, JCY
Guo, X 
Law, LP
Lee, KM
Chow, DHK
Rosier, R
Keywords: Bone morphogenetic protein
Rabbit model
Spinal fusion
Issue Date: 2002
Publisher: Lippincott Williams & Wilkins
Source: Spine, 2002, v. 27, no. 5, p. 467-474 How to cite?
Journal: Spine 
Abstract: Study Design. A rabbit posterolateral intertransverse process fusion model was used to evaluate the effect that different doses of recombinant human bone morphogenetic protein-4 delivered in a porous hydroxyapatite-tricalcium phosphate ceramic had on osteogenesis and spinal fusion. Objective. To study the biologic effect and threshold dose of recombinant human bone morphogenetic protein-4 in enhancing spinal fusion. Summary of Background Data. Biologic manipulation for spinal fusion is an area undergoing active research. The enhancing effects of recombinant human bone morphogenetic proteins 2 and 7 on spinal fusion have been proved, and clinical trials of their application are in progress. Recombinant human bone morphogenetic protein-4 is another osteoinductive protein that has the ability to induce heterotopic bone formation, and its potential for enhancing spinal fusion has not yet been studied. Methods. For this study, 24 adult New Zealand white rabbits underwent single-level unilateral posterior intertransverse process spinal fusion at L5-L6. The animals were divided into four groups using different graft materials: allograft as well as hydroxyapatite-tricalcium phosphate augmented with 0, 1.25, and 5 ug of recombinant human bone morphogenetic protein-4, respectively. The local changes were evaluated by sequential radiograph, manual palpation, histo morphology, and microradiography. Results. At week 7, ossification in the intertransverse process area ceased in groups without recombinant human bone morphogenetic protein-4, whereas active multicentric endochondral bone formation was demonstrated in groups with this growth factor. The success rate of contiguous bony bridging was found to correlate positively with the dose of recombinant human bone morphogenetic protein-4. Conclusions. Recombinant human bone morphogenetic protein-4 effectively enhances new bone formation and accelerates fusion in the rabbit posterolateral posterior spinal fusion model. The effective dose of recombinant human bone morphogenetic protein-4 is 10 times lower than the reported dosage of recombinant human bone morphogenetic proteins 2 and 7.
URI: http://hdl.handle.net/10397/24566
ISSN: 0362-2436
EISSN: 1528-1159
DOI: 10.1097/00007632-200203010-00006
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