The efficacy of rhBMP-2 versus autograft for posterolateral lumbar spine fusion in elderly patients
The efficacy of rhBMP-2 versus autograft for posterolateral lumbar spine fusion in elderly patients
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DOI：
10.1007/s00586-009-1248-6
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发表时间：
2010-06-01
影响因子：
2.8
通讯作者：
Wang, Jeffrey C.
中科院分区：
文献类型：
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作者：
Lee, Kwang-Bok;Taghavi, Cyrus E.;Wang, Jeffrey C.
很少有研究专门检查65岁及以上患者使用rhBMP-2后的结果。本回顾性研究的目的是评估rhBMP-2异体移植与自体移植在65岁及以上患者后外侧腰椎融合中的疗效。127例患者根据融合材料和年龄分为三组。A组（n = 34）为65岁及以上接受rhBMP-2和同种异体移植的患者。B组（n = 52）为年龄小于65岁的患者，采用rhBMP-2和同种异体移植。C组（n = 41）患者年龄在65岁及以上，使用自体移植物。比较两组融合率、融合时间（注意、实）、临床结果、VAS、围手术期并发症及翻修率。A组与C组融合率、融合时间相似;然而，这些低于b组的观察结果。各组之间的临床结果相似。A组和c组的VAS和围手术期并发症发生率无显著差异。在65岁及以上患者中，同种异体bmp -2移植可获得可接受的融合率和融合时间，临床结果良好，围手术期并发症减少。rhBMP-2与同种异体移植物联合应用于老年患者腰椎后外侧固定融合术的效果与自体移植物相当。此外，与65岁以下接受后侧腰椎融合术的患者相比，使用rhBMP-2并不足以克服老年患者遇到的与年龄相关的骨诱导能力减弱的所有方面。
Few studies have specifically examined the outcomes following rhBMP-2 usage in patients 65 years and older. The purpose of this retrospective study is to evaluate the efficacy of rhBMP-2 with allograft versus autograft for posterolateral lumbar fusion in patients 65 years and older. One hundred twenty-seven patients were divided into three groups based on fusion material and age. Subjects in group A (n = 34) consisted of patients 65 years and older who received rhBMP-2 and allograft. Group B (n = 52) was composed of patients under 65 years of age with rhBMP-2 and allograft. Subjects in group C (n = 41) were 65 years and older with autograft use. A comparison was made of fusion rate, fusion time (noticed, solid), clinical outcome, VAS, perioperative complications and revision rate between each group. The fusion rate and fusion time were similar in groups A and C; however, these were lower than that observed in group B. Clinical outcomes were similar amongst the groups. There were no significant differences in VAS and perioperative complication rate between groups A and C. In patients 65 years and older, rhBMP-2 with allograft may lead to acceptable fusion rates and fusion times, good clinical outcomes and reduced perioperative complications. The combination of rhBMP-2 with allograft yields equivalent outcomes as autograft in elderly patients undergoing instrumented posterolateral lumbar fusion. Additionally, when compared to patients under 65 years of age undergoing posterolateral lumbar fusion, the use of rhBMP-2 was not sufficient to overcome all aspects of the age-related weakened osteoinductive capacity encountered in elderly patients.