{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T14:08:25Z","timestamp":1779458905451,"version":"3.53.1"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This retrospective study aimed to evaluate the radiologic outcomes and changes in biochemical inflammatory markers following posterior lumbar interbody fusion (PLIF) with Escherichia coli-derived recombinant human bone morphogenetic protein-2 (E.BMP-2), compared with conventional autologous bone grafting. Methods: The study included 112 patients undergoing single- or two-level PLIF for degenerative lumbar disease between 2022 and 2023, divided into E.BMP-2 (n = 50) and Control (n = 62) groups. Radiological outcomes, including Bridwell grading system and adjacent vertebral body (VB) changes, and changes in biochemical inflammatory markers\u2014white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil count\u2014were assessed. Clinical outcomes were also evaluated. Multivariate regression and propensity-score-matched analyses, and linear mixed-effects models were applied. Results: Fusion rates were comparable between the groups (90.8% vs. 96.7%; p = 0.466); adjusted analyses showed no independent association between E.BMP-2 use and fusion outcomes. The E.BMP-2 group demonstrated a higher prevalence of adjacent VB changes (78.5% vs. 54.3%; p = 0.001), and higher postoperative inflammatory markers including CRP levels on postoperative day 7 and at 1 month, along with increased neutrophil levels on postoperative day 4 (CRP day 7: 31.7 \u00b1 26.4 mg\/L vs. 18.7 \u00b1 14.4 mg\/L, p = 0.014; CRP 1 month: 7.2 \u00b1 13.0 mg\/L vs. 2.7 \u00b1 3.8 mg\/L, p = 0.022; neutrophil count day 4: 64.4 \u00b1 10.6% vs. 60.6 \u00b1 8.7%, p = 0.039). However, no significant differences in clinical outcomes, as assessed by VAS scores, were observed according to adjacent VB changes or inflammatory markers. Postoperative fever and infection rates were similar between groups. Conclusions: E.BMP-2 use in PLIF demonstrated fusion rates comparable to those of autografts, without demonstrated superiority. No significant differences in clinical outcomes were identified. Further large-scale prospective studies are needed to clarify its clinical role and optimal dosing.<\/jats:p>","DOI":"10.3390\/jcm15114026","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:12:08Z","timestamp":1779455528000},"page":"4026","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparable Fusion Response, but Increased Inflammatory Response, with Escherichia coli-Derived Recombinant Human Bone Morphogenetic Protein-2 in Posterior Lumbar Interbody Fusion Surgery"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-8118","authenticated-orcid":false,"given":"Mu Ha","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jun","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Yoon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Uk","family":"Kuh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Kyu","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3384-5638","authenticated-orcid":false,"given":"Keun Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5127-2661","authenticated-orcid":false,"given":"Jae Keun","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1681-9734","authenticated-orcid":false,"given":"Bong Ju","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S136","DOI":"10.1227\/NEU.0000000000000945","article-title":"Trends for Spine Surgery for the Elderly: Implications for Access to Healthcare in North America","volume":"77","author":"Zuckerman","year":"2015","journal-title":"Neurosurgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1016\/j.spinee.2024.03.003","article-title":"Lumbar fusion surgery in the era of an aging society: Analysis of a nationwide population cohort with minimum 8-year follow-up","volume":"24","author":"Kwon","year":"2024","journal-title":"Spine J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1186\/s13018-020-02032-7","article-title":"Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: A meta-analysis","volume":"15","author":"Wang","year":"2020","journal-title":"J. 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