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J Am Acad Orthop Surg, Vol 8, No 1, January/February 2000, 3-9.
© 2000 the American Academy of Orthopaedic Surgeons
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The Role of Human Bone Morphogenetic Proteins in Spinal Fusion

Dan A. Zlotolow, MD, Alexander R. Vaccaro, MD, Michael L. Salamon and Todd J. Albert, MD

Dr. Zlotolow is Clinical Research Fellow, Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia. Dr. Vaccaro is Associate Professor of Orthopaedic Surgery, The Rothman Institute. Mr. Salamon is Research Assistant, Thomas Jefferson University. Dr. Albert is Associate Professor of Orthopaedic Surgery, The Rothman Institute.

Reprint requests: Dr. Vaccaro, The Rothman Institute, 925 Chestnut Street, Philadelphia, PA 19107.

The attainment of a stable arthrodesis is critical to the successful management of some types of spinal disorders. Autologous iliac-crest bone graft has been the most commonly utilized substance associated with predictable healing in spinal fusion applications. Although alternative graft substances exist, these have not been shown to be as uniformly effective in achieving spinal fusion. Because of the morbidity associated with bone autograft harvest, there is increasing interest in alternative graft substances and especially in the osteoinductive abilities of bone morphogenetic proteins (BMPs). Several animal models have demonstrated that BMP-containing allograft or synthetic carrier medium is as effective as or superior to autograft bone in promoting spinal fusion. Furthermore, the limited number of human trials utilizing BMPs to treat nonunions in the appendicular skeleton indicate that the results found in animal models will be reproducible in the clinical setting.




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