Article information
Introducción
Una artrodesis sobre raquis tiene dos pasos claramente diferenciados: la colocación de un sistema de fijación y la adición de una sustancia osteogénica, generalmente tejido óseo, que pretende estimular la formación de hueso entre los niveles deseados.
Biología molecular de las BMPLas proteínas morfogenéticas del hueso (BMP) participan en la multiplicación, diferenciación, muerte programada (apoptosis) y morfogénesis.
Sustitutos óseosEl sustituto óseo ideal siempre ha sido el injerto autólogo, que provee células vivas del propio individuo y factores de crecimiento (FC), además de hueso propiamente dicho. Todos los nuevos sustitutos que han ido apareciendo deben cumplir con las condiciones fundamentals del autoinjerto, pero no con sus inconvenientes, entre los que se encuentran la morbilidad de la zona donante y la cantidad limitada de la que se dispone.
Factores de crecimientoAunque actualmente existen publicaciones donde se muestra que la administración de FC en la artrodesis vertebral estimula la osteogénesis, se desconoce la forma de administración con relación a la dosis, transportadores o momento de administrar cada factor.
Terapia génicaLa ingeniería genética, aun siendo una apuesta de futuro importante, necesita todavía mucho camino para ser una realidad en la aplicación para la promoción de la osteogénesis terapéutica.
Palabras clave:
raquis
cirugía
osteogénesis
biología
Introduction
Spinal fusion has two clearly differentiated steps: a fixation system and addition of an osteogenic substance, generally bone tissue, intended to stimulate bone formation between levels.
Molecular biology of BMPBMPs participate in multiplication, differentiation, programmed death (apoptosis), and morphogenesis.
Bone substitutesThe ideal bone substitute has always been an autologous graft, which supplies living cells and GF from the host, in addition to bone. Any new substitute should meet the basic conditions of an autograft without its drawbacks, which include damage to the harvest area and a limited harvest.
Growth factorsAlthough it has been reported that the administration of growth factors stimulates osteogenesis during spinal fusion, the specifics of administration such as optimal dose and suitable transporters and timing are unknown for each factor.
Gene therapyGenetic engineering, although an important option for the future, still requires work to become a reality in therapeutic osteogenesis.
Keywords:
spine
surgery
osteogenesis
biology
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