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Abstract
The impact of autologous iliac crest bone graft versus BMP-2 to improve fusion rates for posterolateral fusion (PLF) of the
lumbar spine remains unanswered. Single-institution-centered data dominate the literature, providing results that may be
contradictory or inconclusive. The aim of this paper is to analyze data pooled from multiple well-controlled studies that
examined both ICBG and BMP-2 for use in PLF. This meta-analysis also provides details of success in different subsets of
patients with variable risk factors for delayed and non-unions. Six high-quality randomized clinical trials were selected.
Efficacy, morbidity, quality of life, and safety were compared between the BMP-2 group and the ICBG group. A total of 908
patients were included in the study. At 24 months, 94% of patients achieved fusion in the BMP-2 group and 83% in the ICBG
group. At 6 and 12 months, the fusion was also greater in the BMP-2 group (86% vs. 60% and 88% vs. 80%, respectively).
Surgical time, intraoperative blood loss, and hospitalization days also showed significant differences in favor of the experimental
group (p < 0.01). There were no differences between two groups in the Oswestry Disability Index, 36-Item Short
Form Health Survey and Back Pain Score, whereas a greater number of additional surgical procedures were performed in
the ICBG group (p = 0.001). In conclusion, the use of BMP-2 in PLF reduced the surgical morbidity and had more beneficial
effects on the fusion rate. The quality of life based on clinical scores was the same in both groups.
Dinos que te ha parecido este artículo, Puntúa (DE 1 A 5 ESTRELLAS).
