Application of Escherichia coli-Derived Recombinant Human Bone Morphogenic Protein-2 to Unstable Spinal Fractures
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients Undergoing Spinal Surgery
2.2. Surgical Techniques
2.3. Radiologic and Clinical Parameters
2.4. Statistical Analysis
3. Results
3.1. Patient Demographics
3.2. Radiographic Outcomes
3.3. Clinical Outcomes
3.4. Representative Case
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Number (Percent) |
---|---|
Number of patients | 10 |
Sex (M:F) | 5:5 |
Age (years) | 71.7 ± 7.9 |
Smoking | 2 (20%) |
Bone mineral density (T-score) | −1.6 ± 1.7 |
Fractured level | D11: 1 D12: 3 L1: 4 L3: 1 L5: 1 |
Level of fusion | 4.1 ± 1.0 |
Cement augmentation | 4 (40%) |
Operation time (minutes) | 184.6 ± 70.0 |
Bleeding (mL) | 315.0 ± 152.8 |
ASA (1:2:3:4) | 0:9:1:0 |
Patients | Age/Sex | Diagnosis | Fused Level | Anabolic Agent | Radiographic Healing (Days) | Follow-Up Period (Months) |
---|---|---|---|---|---|---|
1 | 71/M | L5 unstable burst fracture | L3-S1 with S2AI screws | Teriparatide (3 months) | 96 | 17 |
2 | 75/M | D12 chalky stick fracture Underlying AS | D10-L2 (D10, L2 cement augmentation) | Teriparatide (6 months) | 173 | 13 |
3 | 81/F | D12 chalky stick fracture Underlying AS | D9-L2 (L2 cement augmentation) | Teriparatide (8 months) | 100 | 23 |
4 | 75/F | L1 unstable burst fracture | D11-L2 (D11,12,L2 cement augmentation) | Teriparatide (1 month) | 68 | 18 |
5 | 68/M | L3 flexion-distraction injury | L1–4 | Teriparatide (1 month) | 83 | 18 |
6 | 70/M | L1 unstable burst fracture | D11–L2 | Teriparatide (5 months) | 67 | 17 |
7 | 78/F | L1 unstable burst fracture Combined prevertebral abscess | D10–L3 | Teriparatide (1 month) → Romosozumab (7 months) | 84 | 13 |
8 | 74/F | D12 unstable burst fracture | D10–L2 | Romosozumab (12 months) | 192 | 12 |
9 | 52/M | L1 unstable burst fracture | D11–L3 | None | 74 | 12 |
10 | 73/F | D11 unstable burst fracture | D8–L2 (L2 cement augmentation) | Teriparatide (2 months) → Romosozumab (6 months) | 62 | 12 |
Total | - | - | 4.1 ± 1.0 levels | 5.2 ± 3.9 months | 99.9 ± 45.4 | 15.5 ± 3.7 |
LKA | AVH | VWA | |
---|---|---|---|
Pre-operative | 9.9 ± 17.9 | 19.1 ± 8.3 | 12.3 ± 8.3 |
Post-operative | −0.8 ± 16.5 | 28.7 ± 3.2 | 2.5 ± 4.6 |
p-value * | 0.002 | 0.001 | 0.001 |
Last follow-up | 3.8 ± 18.6 | 26.4 ± 4.9 | 4.7 ± 5.6 |
p-value ** | 0.072 | 0.006 | 0.006 |
Pre-Operative | Last Follow-Up | p-Value | |
---|---|---|---|
NRS (back pain) | 8.6 ± 1.8 | 3.7 ± 1.8 | <0.001 |
NRS (leg pain) | 3.4 ± 3.7 | 2.4 ± 2.3 | 0.393 |
ODI | 67.8 ± 17.5 | 36.0 ± 13.3 | 0.002 |
EQ-5D index | 0.21 ± 0.28 | 0.68 ± 0.18 | 0.001 |
ASIA impairment scale | |||
A | 0 | 0 | - |
B | 0 | 0 | |
C | 1 | 0 | |
D | 3 | 1 | |
E | 6 | 9 |
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Kim, Y.-H.; Lee, J.-S.; Ha, K.-Y.; Kim, S.-I.; Jung, H.-Y.; Kim, G.-U.; Joh, Y.; Park, H.-Y. Application of Escherichia coli-Derived Recombinant Human Bone Morphogenic Protein-2 to Unstable Spinal Fractures. Bioengineering 2023, 10, 1114. https://doi.org/10.3390/bioengineering10101114
Kim Y-H, Lee J-S, Ha K-Y, Kim S-I, Jung H-Y, Kim G-U, Joh Y, Park H-Y. Application of Escherichia coli-Derived Recombinant Human Bone Morphogenic Protein-2 to Unstable Spinal Fractures. Bioengineering. 2023; 10(10):1114. https://doi.org/10.3390/bioengineering10101114
Chicago/Turabian StyleKim, Young-Hoon, Jun-Seok Lee, Kee-Yong Ha, Sang-Il Kim, Ho-Young Jung, Geon-U Kim, Yongwon Joh, and Hyung-Youl Park. 2023. "Application of Escherichia coli-Derived Recombinant Human Bone Morphogenic Protein-2 to Unstable Spinal Fractures" Bioengineering 10, no. 10: 1114. https://doi.org/10.3390/bioengineering10101114