Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (5): 62-66.doi: 10.6040/j.issn.1671-7554.0.2019.297

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Application of bone morphogenetic protein combined with posterolateral fusion in the treatment of lumbar degenerative diseases

XIA Haipeng, ZHENG Yanping, ZHOU Chao, YIN Jun, CONG Wei   

  1. Department of Orthopedics, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To evaluate the clinical efficacy of bone morphogenetic protein(BMP)combined with posterolateral fusion(PLF)in the treatment of lumbar degenerative diseases. Methods The clinical data of 66 patients with lumbar degenerative diseases who underwent PLF during Jan. 2014 and Nov. 2017 were retrospectively analyzed, including 34 males and 32 females, aged 36-79 years, average(54.5±14.2)years. The disease involved single segment, double segments and three segments in 26, 28 and 12 cases, respectively. Lumbar spinal stenosis, lumbar spondylolisthesis(I°)and far lateral lumber disc herniation occurred in 45, 11 and 10 cases, respectively. The main clinical manifestations were low back pain, lower extremity pain and anesthesia. After decompression through the minimally invasive Wiltse approach, bone grafting bed was prepared by high-speed burr. PLF was performed on 23 sides with autologous bone alone, 33 sides with autologous and allogeneic bone, 32 sides with autologous bone and BMP, 19 sides with alloge- 山 东 大 学 学 报 (医 学 版)57卷5期 -夏海鹏,等.骨形态发生蛋白结合后外侧融合在腰椎退行性疾病手术中的应用 \=-neic bone and BMP, and 25 sides with autologous and allogeneic bone and BMP. BMP was routinely used in the left side, and used in both sides in 13 patients. The clinical efficacy was evaluated with Oswestry disability index(ODI)and visual analogue scale(VAS), and the fusion rate was evaluated with Suk. Results The patients were followed up for 12-24 months, average(14.7±3.2)months. One year after surgery, VAS score and ODI were significantly improved, and no clinical complications occurred. As the postoperative follow-up prolonged, the fusion rate 3 months, 6 months and 1 year after surgery for the autologous bone sides was 52%, 65% and 96%, for the autologous bone + allogeneic bone sides was 52%, 64%, 94%, for the autologous bone + BMP sides was 84%, 88% and 94%, for the allogeneic bone + BMP sides was 84%, 89%, 95%, and for the autologous bone + allogeneic bone + BMP sides was 84%, 88% and 96%, respectively. Conclusion PLF is safe, effective and minimal invasive in the treatment of lumbar degenerative diseases. BMP can improve the short-term fusion rate of PLF, but does not affect the long-term fusion rate.

Key words: Bone morphogenetic protein, Posterolateral fusion, Lumbar degenerative disease, Wiltse approach

CLC Number: 

  • R681.5
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