Application Of RhBMP-2 Combined With Autogenous Ilium Bone Graft In Posterior Atlantoaxial Pedicle Screw Fixation And Bone Graft Fusion

purpose:To evaluate the safety and effectiveness of recombinant human bone morphogenetic protein-2(rhBMP-2)combined with autogenous iliac bone graft in posterior atlantoaxial pedicle screw fixation and bone graft fusion.Methods:The posterior atlantoaxial reduction and fixation and bone grafting fusion using BMP-2 combined with autogenous iliac bone grafting for 54 cases of atlantoaxial dislocation(group BMP-2)and only autologous iliac bone grafting for 63 cases(group autograft)from December 2017 to December 2021 were retrospectively analyzed and compared.The operation time,bleeding volume,VAS score,JOA score,NDI,C0-2 vertebral body activity 12 month after operation and time of bone graft fusion were compared between the two groups.The data of the two groups were compared and analyzed using the software SPSS 23.0.the qualitative data were analyzed by X~2test or Fisher’s exactly test and the quantitative data were analyzed by t-test.The difference was statistically significant with a P<0.05.Result:117 patients were followed up for an average of(20.8±2.6)months.The imaging examination showed that satisfactory bony fusion and the fusion rate was100%at 12 months after operation.No vertebral artery,nerve,spinal cord injury,cerebrospinal fluid leakage,incision infection and broken internal fixation device occurred in both groups.There was no significant difference in age,sex,operation time,bleeding volume and etiology distribution between the two groups(P>0.05).The VAS score,JOA score and NDI at 12 months after operation in both groups were significantly improved compared with those before treatment(P<0.05).There was no significant difference between the two groups in VAS score,JOA score,NDI,C0-2vertebral body activity(P>0.05)at 12 months after operation.The comparison of fusion time between the two groups found that the use of autologous bone combined with rhBMP-2 interlaminar bone graft had a shorter bone fusion time(P<0.05).Conclusion:Autogenous bone combined with rhBMP-2 in posterior atlantoaxial pedicle screw internal fixation and bone graft fusion is more conducive to obtaining bone graft fusion after operation,shortening the time of bone fusion,and recovering the cervical function well,but the long-term effect still needs further study.