腰椎融合中自体髂骨植骨与骨形态发生蛋白2比较的Meta分析

Autogeneic iliac crest graft versusbone morphogenetic protein 2 in lumbar fusion: a Meta-analysis

BACKGROUND: As a substitute for autogeneic iliac crest, bone morphogenetic protein 2 has been widely used in lumbar fusion and relative trials. OBJECTIVE: To assess the effectiveness and safety of bone morphogenetic protein 2 in lumbar fusion. METHODS: CBM, Medline, Embase and the Cochrane Central Register of Controlled Trial databases were retrieved for relevant randomized controlled trials of bone morphogenetic protein 2 versus autogenous iliac crest graft in lumbar fusion published before September 2015. A Meta-analysis was performed utilizing the Cochrane system. RESULTS AND CONCLUSION: Totally 14 randomized controlled trials met the inclusion criteria, including 1 613 patients. Meta-analysis results showed that the reoperation rate and operation time in bone morphogenetic protein 2 group were significantly less than those in the autogenous iliac crest graft group (P ≤ 0.01), and the fusion rate was significantly higher than that in the autologous iliac crest graft group (P ≤ 0.01). There were no significant differences in the clinical outcomes, complications, intraoperative blood loss, hospitalization time, patient satisfaction and work status after surgery between two groups. Based on the limited evidence, bone morphogenetic protein 2 for lumbar degenerative disease exerts no significant superiority to the autologous iliac crest graft. Moreover, more high-quality randomized controlled trials with long-term follow-up are needed to further assess the effectiveness and safety of bone morphogenetic protein 2 in lumbar fusion.