Methods for assessing the effectiveness of using bone morphogenetic proteins in spondylodesis

BACKGROUND: Today, growth factors, in particular bone morphogenetic proteins in the composition of osteoplastic materials, are widely used to accelerate bone tissue regeneration after injuries or diseases of the musculoskeletal system. There are various methods for evaluating the effectiveness of using these proteins, in particular, the methods for medical imaging and determining specific markers. Bone loss often occurs after trauma or injury, including surgery. Rapid impairment of bone formation and increased bone resorption, as reflected by biochemical markers of bone metabolism, may cause this bone loss. Therefore, the detection of these markers in patients after spinal fusion using bone morphogenetic proteins is important in assessing the effectiveness of this therapy at various stages of observation in the postoperative period. However, due to the widespread use of bone morphogenetic proteins, their therapeutic efficacy can increasingly be seen in everyday radiological practice. X-ray or computed tomography is usually used to assess the effectiveness of the surgical intervention. Magnetic resonance imaging may be a useful adjunct, however, postoperative magnetic resonance imaging analysis is vulnerable to hardware artifacts. Although there is extensive data in the literature on the outcomes of surgical interventions for spondylodesis using bone morphogenetic proteins, radiographic data and data on the detection of specific markers and their use are scarce. AIM: In this study, we will discuss the current knowledge about existing and possible methods for evaluating the effectiveness of the use of bone morphogenetic proteins in spondylodesis. MATERIALS AND METHODS: Using PubMed, Embase, the Cochrane Database, and Google Scholar, we conducted a comprehensive literature search demonstrating possible methods for evaluating the effectiveness of bone morphogenetic proteins in spondylodesis. RESULTS: This study presents various methods for determining the effectiveness of the use of bone morphogenetic proteins in spondylodesis. In addition, the results of preclinical and clinical studies, which analyzed the effectiveness of the use of bone morphogenetic proteins, have been analyzed. CONCLUSIONS: To identify the effectiveness of bone morphogenetic proteins in spondylodesis further preclinical and clinical studies are required.