{
  "abstract": "Background: Extreme lateral lumbar interbody fusion (XLIF) requires reliable graft material for arthrodesis. Bone morphogenetic protein-2 (BMP-2) is osteoinductive but costly and may cause complications. β-Tricalcium phosphate (β-TCP) combined with iliac crest bone graft (ICBG) may provide an alternative. This study compared the radiographic and clinical outcomes of BMP-2 versus β-TCP + ICBG in single-level XLIF.\n\nMaterial/Methods: This ambidirectional observational cohort included 79 consecutive patients who underwent single-level XLIF from 2014 to 2024 (BMP-2, 45; β-TCP + ICBG, 34). The Oswestry Disability Index (ODI), EuroQol 5-Dimension 5-Level (EQ-5D-5L), and EuroQol Visual Analog Scale (EQ-VAS) were assessed preoperatively and at 24 months. Radiographic alignment was evaluated preoperatively and at 24 months. Fusion was assessed at 12 and 24 months using computed tomography-supported criteria supplemented by dynamic radiographs.\n\nResults: Baseline characteristics and surgical indications were similar between groups. Fusion rates at 12 months were 75.6% with BMP-2 and 55.9% with β-TCP + ICBG (P = 0.065), increasing to 100% and 97.1%, respectively, at 24 months (P = 0.247). Both groups showed substantial improvements in ODI and EQ-5D-5L, without significant between-group differences at 24 months. Intervertebral disc height significantly increased in both groups, whereas foraminal height was maintained. Complication rates were comparable.\n\nConclusions: Both grafting strategies produced favorable radiographic and clinical outcomes at 24 months. BMP-2 showed a numerically higher 12-month fusion rate, whereas β-TCP + ICBG achieved a similar final fusion rate. Given the observational design and limited sample size, these findings support β-TCP + ICBG as a potential alternative but do not establish equivalence.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand",
    "Division of Orthopaedics, Golden Jubilee Medical Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Werasak Sutipornpalangkul"
    },
    {
      "affs": [
        0
      ],
      "name": "Apicha Leardthanadee"
    },
    {
      "affs": [
        0
      ],
      "name": "Monchai Ruangchainikom"
    },
    {
      "affs": [
        0
      ],
      "name": "Ekkapoj Korwutthikulrangsri"
    },
    {
      "affs": [
        1
      ],
      "name": "Panlop Tirawanish"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e1kb0jz5t421y.bib",
  "cited_by": 0,
  "doi": "10.12659/msm.953610",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13729680/",
  "id": "e1kb0jz5t421y",
  "issns": [
    "1234-1010",
    "1643-3750"
  ],
  "landing_url": "https://doi.org/10.12659/msm.953610",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Research"
    ],
    [
      "openalex",
      "2732|Spine and Intervertebral Disc Pathology"
    ]
  ],
  "openalex": "W7204547045",
  "pdf_url": "https://medscimonit.com/download/inPress/idArt/953610",
  "pmcid": "PMC13729680",
  "pmid": "42958654",
  "published": "2026-10-30",
  "publisher": "International Scientific Information, Inc.",
  "ris": "https://research.draconitic.com/paper/e1kb0jz5t421y.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:26Z",
      "native_id": "PMC13729680",
      "source": "pmc",
      "url": "https://doi.org/10.12659/msm.953610"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Spine and Intervertebral Disc Pathology",
      "subfield": "surgery"
    }
  ],
  "title": "Comparison of Radiographic and Clinical Outcomes Between Bone Morphogenetic Protein-2 and β-Tricalcium Phosphate Combined With Iliac Crest Bone Graft in Single-Level Extreme Lateral Interbody Fusion: An Ambidirectional Cohort Study",
  "title_text": "Comparison of Radiographic and Clinical Outcomes Between Bone Morphogenetic Protein-2 and β-Tricalcium Phosphate Combined With Iliac Crest Bone Graft in Single-Level Extreme Lateral Interbody Fusion: An Ambidirectional Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:26Z",
  "url": "https://research.draconitic.com/paper/e1kb0jz5t421y",
  "venue": "Medical Science Monitor: International Medical Journal of Experimental and Clinical Research",
  "versions": []
}