Vertebral bone resorption after transforaminal lumbar interbody fusion with bone morphogenetic protein (rhBMP-2)

被引:162
作者
McClellan, John W.
Mulconrey, Daniel S.
Forbes, Robert J.
Fullmer, Nancy
机构
[1] Nebraska Spine Ctr, Omaha, NE 68154 USA
[2] Univ Nebraska, Med Ctr, Omaha, NE USA
[3] Diagnost Radiol PC, Omaha, NE USA
来源
JOURNAL OF SPINAL DISORDERS & TECHNIQUES | 2006年 / 19卷 / 07期
关键词
rhBMP-2; osteolysis; transforaminal lumbar interbody fusion;
D O I
10.1097/01.bsd.0000211231.83716.4b
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Bone morphogenetic protein (rhBMP-2) has demonstrated an increased rate of interbody fusion when placed in the intervertebral space. Owing to this advantage, rhBMP-2 is being implanted with increasing frequency in the lumbar spine. The purpose was to quantify and describe the presence of bone resorption within the vertebral body after transforaminal lumbar interbody fusion with placement of rhBMP-2 within the disc space. Methods: Twenty-six patients were selected from a clinical database. Patients included in the study had undergone a transforaminal lumbar interbody fusion with BMP. Interbody implants included allograft dowels or interbody cages augmented with autograft or allograft bone. A computed tomography study of the lumbar spine a minimum of 3-month postoperatively was another inclusion criterion. Osteolytic defects were grouped into 3 categories on the basis of the size and extent of involvement in the vertebral body. Results: A total of 32 lumbar levels were reviewed. Fourteen males and 12 females with an average age of 46.0 years were included in the study. Bone resorption defects were noted in 22 of the 32 levels reviewed (69%). The defects were characterized as mild in 50% (11 of 22), moderate in 18% (4 of 22), and severe in 31% (7 of 22). Conclusions: The benefit of rhBMP-2 to promote interbody fusion in the lumbar spine has been well documented. BMP has demonstrated an increased fusion rate and the ability to produce a robust fusion mass. rh-BMP-2's osseous remodeling potential may lead to bone resorption within the vertebral body.
引用
收藏
页码:483 / 486
页数:4
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