How does recombinant human bone morphogenetic protein-4 enhance posterior spinal fusion?

Jack C. Y. CHENG, Xia GUO, Lai Pang LAW, Kwong Man LEE, Hung Kay Daniel CHOW, Randy ROSIER

Research output: Contribution to journalArticle

25 Citations (Scopus)

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 μg of recombinant human bone morphogenetic protein-4, respectively. The local changes were evaluated by sequential radiograph, manual palpation, histomorphology, 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. Copyright © 2002 Lippincott Williams & Wilkins, Inc.

Original languageEnglish
Pages (from-to)467-474
JournalSpine
Volume27
Issue number5
DOIs
Publication statusPublished - 01 Mar 2002

Fingerprint

Spinal Fusion
Osteogenesis
Durapatite
Rabbits
Microradiography
human BMP4 protein
Palpation
Allografts
Intercellular Signaling Peptides and Proteins
Clinical Trials
Transplants

Citation

Cheng, J. C. Y., Guo, X., Law, L. P., Lee, K. M., Chow, D. H. K., & Rosier, R. (2002). How does recombinant human bone morphogenetic protein-4 enhance posterior spinal fusion? Spine, 27(5), 467-474. doi: 10.1097/00007632-200203010-00006

Keywords

  • Bone morphogenetic protein
  • Rabbit model
  • Spinal fusion