Bone morphogenetic proteins for spinal fusion.
Bone morphogenetic proteins for spinal fusion.
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DOI：
10.1016/j.spinee.2005.02.014
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发表时间：
2005-11-01
期刊：
影响因子：
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通讯作者：
Fischgrund, Jeffrey S
中科院分区：
文献类型：
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作者：
Carlisle, Elliot;Fischgrund, Jeffrey S
背景：1965年，马歇尔乌里斯特发现骨的细胞外基质具有诱导新骨形成的能力。这种物质后来被命名为骨形态发生蛋白（BMP）。从那时起，BMP就被广泛研究。分子克隆已经被表征并表达为互补DNA（cDNA）。BMP最近已被用于许多哺乳动物临床研究，包括许多最近的人类研究，目的是评估其在骨愈合和脊柱关节固定中的功能。骨形成蛋白是目前最有效的替代骨移植作为一种手段，以消除发病率的髂嵴骨移植收获和提高成功率的脊柱arthrodesis.Purpose：本文的目的是审查的历史和最近的进展，在使用骨形成蛋白在脊柱arthrodesismodels，以及讨论可能的未来使用骨形成蛋白在这种临床设置。这篇综述文章的设置是集中在经典和最近的文献骨形态发生蛋白强调前以及后外侧spinal arthrodesis.METHODS：经典和最近的主要文献骨形态发生蛋白及其临床应用在人类和非人类哺乳动物的脊柱融合进行了审查。重点介绍了重组人骨形态发生蛋白-2（rhBMP-2）和重组人成骨蛋白-1（rhOP-1、rhBMP-7）的动物和人体研究。结果：在动物研究和早期人体试验中，BMP在脊柱前、后外侧环境中都能促进脊柱的牢固融合。迄今为止，人体试验也显示出可接受的安全性与临床使用这些proteins.CONCLUSIONS：动物研究和骨形态发生蛋白的早期人体试验支持这些生长因子的能力，以提高或取代自体骨脊柱arthrodesis。研究表明，在前路椎间融合器和后外侧环境中均能促进融合。这些因素的未来使用可能会在临床和研究领域继续扩大。
BACKGROUND CONTEXT: In 1965, Marshall Urist discovered that the extracellular matrix of bone contains the ability to induce new bone formation. This substance was later named bone morphogenetic protein (BMP). Since that time, BMPs have been extensively studied. Molecular clones have since been characterized and expressed as complementary DNAs (cDNAs). BMPs have recently been used in a multitude of mammalian clinical studies, including many recent human studies, for the purpose of evaluating their function in bone healing and spinal arthrodesis. BMPs are currently the most effective substitute available for bone graft as a means to eliminate the morbidity of iliac crest bone graft harvest and increase the rate of successful spinal arthrodesis.PURPOSE: The purpose of this article is to review the history and recent advancements in the use of BMPs in spinal arthrodesis models, as well as discuss the possible future use of BMPs in this clinical setting.STUDY DESIGN/SETTING: The setting of this review article is centered on classic and recent literature of BMPs with emphasis on anterior as well as posterolateral spinal arthrodesis.METHODS: The classic and recent primary literature about BMPS and their clinical use in human and nonhuman mammals for spinal fusion was reviewed. Special emphasis is placed on animal and human studies of both recombinant human bone morphogenetic protein-2 (rhBMP-2) and recombinant human osteogenic protein-1 (rhOP-1, rhBMP-7).RESULTS: BMPs are able to promote solid fusion in the spine in both the anterior and the posterolateral environments in animal studies and early human trials. Human trials to date have also shown an acceptable safety profile with the clinical use of these proteins.CONCLUSIONS: Animal studies and early human trials of BMPs support the ability of these growth factors to enhance or replace autograft bone for spinal arthrodesis. Studies have shown this promotion of fusion in both the anterior interbody and the posterolateral environments. Future use of these factors is likely to continue to expand in clinical as well as research arenas.