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Review
. 2016 Jun 22;52(2):124-140.
doi: 10.1016/j.rboe.2016.03.005. eCollection 2017 Mar-Apr.

The use of bone morphogenetic proteins (BMP) and pseudarthrosis, a literature review

Oberdan Ribeiro Gonçalves de Oliveira  1 , Saul Pinheiro Rebouças Martins  1 , Wyvison Gomes de Lima  1 , Marília Maia Gomes  1
Affiliations
Review

The use of bone morphogenetic proteins (BMP) and pseudarthrosis, a literature review

Oberdan Ribeiro Gonçalves de Oliveira et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Bone morphogenetic proteins (BMP) are multi-functional growth factors to promote bone healing with the proposal of less morbidity compared to the usual methods of bone graft harvest. Pseudoarthrosis occur when the fusion attempt fails, a solid fusion is not achieved, or there is motion across the segment leading to it, and it can be clinically symptomatic as pain, deformity, neurocompression, or hardware failure. BMPs are used at spinal fusion as a tool for the treatment of degenerative, traumatic, neoplastic and infectious conditions of the spine. This review shows that the use of BMPS is effective and secure when compared with iliac crest bone graft (ICGB); however, depending of the location of usage (cervical spine, lumbar spine or sacrum) and the medical status of the patient (presence of comorbidities, tobacco usage), it is more likely to exhibit complications. Therefore, the use of these proteins must be an informed decision of patient and physician preferences.

Proteínas morfogenéticas do osso (Bone morphogenetic proteins [BMP]) são fatores de crescimento multifuncionais que promovem cicatrização óssea, propondo menos comorbidades comparado aos métodos usuais de colheita de enxerto ósseo. Pseudoartroses ocorrem quando a tentativa de fusão óssea falha, uma fusão sólida não é atingida ou quando há movimentação do segmento que leva à pseudoartrose, que pode ser clinicamente sintomática com dor, deformidade, neurocompressão ou falha na colocação de material de síntese. As BMPs são usadas em fusão colunar como ferramenta para o tratamento de trauma degenerativo, condições neoplásicas e infecciosas da coluna. A presente revisão da literatura mostra que o uso de BMPs é efetivo e seguro quando comparado com enxerto ósseo ilíaco. No entanto, a depender do local de uso (coluna cervical ou lombar ou sacro) e do estado médico do paciente (presença de comorbidades, tabagismo) é mais propício o aparecimento de complicações. Portanto, o uso dessas proteínas deve ser decidido após uma decisão conjunta de preferências médicas e do paciente.

Keywords: Bone morphogenetic protein 2; Bone morphogenetic proteins 7; Pseudarthrosis.

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References

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