Applications of Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) in Spinal Surgery

Animal studies and clinical trials have demonstrated the efficacy of rhBMP-2 as an adjunct or substitute to autogenous bone graft in anterior lumbar interbody fusion, posterolateral fusion, and in overcoming inhibitory effects (ketolorac and nicotine) on fusion. Importantly, no serious adverse events or systemic side effects have been observed in clinical trials. Before widespread application of rhBMP-2 can be accepted, future investigations are needed to evaluate its efficacy in various spinal disorders, optimal dose and delivery system, long-term safety profile (immunogenicity, antibody formation), cost-effectiveness of therapeutic growth factors, and non-fusion application in altering the progression of degenerative disc disease.