Abstract | STUDY DESIGN: OBJECTIVE: SUMMARY OF BACKGROUND DATA: rhBMP-2 is being used to augment spinal fusion. However, complications such as heterotopic ossification and local soft tissue swellings have been reported. These are attributed to supraphysiological amount of rhBMP-2 and the poor modulation capacity of absorbable collagen sponge. METHODS: Forty rats were randomized into 6 groups as follows. Group I: absorbable collagen sponge without rhBMP-2 (n = 4); group II: positive control, absorbable collagen sponge + 10 μg rhBMP-2 (n = 4); group III: alginate-(poly-L-lysine)- heparin (PEC) without rhBMP-2 (n = 8); group IV: PEC + 4.5 μg rhBMP-2 (n = 8); group V: PEC + 1.5 μg rhBMP-2 (n = 8); group VI: PEC + 0.5 μg rhBMP-2 (n = 8). RESULTS: Between postoperative days 5 and 7, seroma was observed in all rhBMP-2 implanted groups irrespective of carrier and dose. However, the rate and size of seroma differed considerably. Although all animals (100%) in positive control group showed seroma, only one animal (12.5%) in group VI developed seroma at the implant site. The size of seroma in group VI was significantly smaller than that in positive control group. Micro-computed tomography evaluation revealed comparable mean fusion scores in all rhBMP-2 implanted groups. More importantly, although new bone was well contained within the cage in group VI, heterotopic ossification beyond the cage was observed in positive control group. CONCLUSION: A new carrier has demonstrated capacity to minimize seroma formation as well as heterotopic ossification associated with rhBMP-2 by reducing the efficacious dose needed for consistent fusion. The results of this study indicate that PEC alginate microbeads may represent a new opportunity to define an efficient rhBMP-2 carrier.
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Authors | Ming Wang, Sunny Akogwu Abbah, Tao Hu, Soo Yein Toh, Raymond Wing Moon Lam, James Choh-Hong Goh, Hee-Kit Wong |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 38
Issue 17
Pg. 1452-8
(Aug 01 2013)
ISSN: 1528-1159 [Electronic] United States |
PMID | 23380826
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Alginates
- Anticoagulants
- Bone Morphogenetic Protein 2
- Drug Carriers
- Recombinant Proteins
- Transforming Growth Factor beta
- recombinant human bone morphogenetic protein-2
- Polylysine
- Heparin
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Topics |
- Alginates
(chemistry)
- Animals
- Anticoagulants
(chemistry, pharmacology)
- Bone Morphogenetic Protein 2
(adverse effects, chemistry, pharmacology)
- Drug Carriers
(chemistry)
- Heparin
(chemistry, pharmacology)
- Humans
- Inflammation
(chemically induced, prevention & control)
- Microspheres
- Ossification, Heterotopic
(chemically induced, prevention & control)
- Polylysine
(chemistry)
- Random Allocation
- Rats
- Rats, Sprague-Dawley
- Recombinant Proteins
(adverse effects, chemistry, pharmacology)
- Seroma
(chemically induced, prevention & control)
- Spinal Fusion
(methods)
- Transforming Growth Factor beta
(adverse effects, chemistry, pharmacology)
- Treatment Outcome
- X-Ray Microtomography
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