Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (53): 10043-10047.doi: 10.3969/j.issn.2095-4344.2012.53.031

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Meta analysis on the efficacy of osteogenic protein-1 and autologous bone graft for posterolateral lumbar fusion

Xing Dan1, Ma Xin-long1, 2, Song Dong-hui3, Ma Jian-xiong1, Wang Jie1, Chen Yang2, Yang Yang2   

  1. 1Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, China
    2Tianjin Hospital, Tianjin 300211, China
    3Department of Orthopedics, Tianjin Public Security Hospital, Tianjin 300042, China
  • Received:2012-03-29 Revised:2012-05-04 Online:2012-12-30 Published:2012-12-30
  • Contact: Ma Xin-long , Master, Professor, Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, China; Tianjin Hospital, Tianjin 300211, China mjx969@163.com
  • About author:Xing Dan★, Studying for master’s degree, Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, China lovetroy@126.com

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Abstract:

BACKGROUND: How to improve lumbar fusion rates and reduce complications after lumbar spinal fusion is an important topic of orthopedics.
OBJECTIVE: To collect and analyze the literatures and to evaluate the effectiveness and security of osteogenic protein-1 and autologous bone graft for posterolateral lumbar fusion.
METHODS: A computer-based search was performed on PubMed database and Embase database combined with manual search for the articles relate to the effect of osteogenic protein-1 and autologous bone graft for posterolateral lumbar fusion according to the inclusion and exclusion criteria. The radiographically nonunion rate, operating time, blood loss and hospitalization days of these two materials were compared. Parts of the data were processed by Meta-analysis, and the odds ratio and 95% confidence interval of the outcome indicators were estimated.
RESULTS AND CONCLUSION: A total of 4 related papers including four randomized control trials were included. There were 109 patients, among them 61 patients were fused with osteogenic protein-1 and 48 patients were fused with autologous bone graft. There was no significant difference of radiographically demonstrated nonunion rate [odds ratio=1.16, 95% confidence interval (0.44, 3.07)], operation time, blood loss, hospitalization days, reoperation rate, Oswestry disability index between osteogenic protein-1 and autologous bone graft (P > 0.05). There was no intervention related adverse event appeared. Osteogenic protein-1 may be an effective and safe alternative to autologous bone graft in posterolateral lumbar fusion. The most important advantage was that the osteogenic protein-1 could avert the morbidity of harvesting bone from the iliac crest and also could meet the need of adequate quantity of bone graft. Current literature needs large, well designed and conducted randomized control trials in clinical appplication.

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