Bone Morphogenetic Protein Usage in Anterior Lumbar Interbody Fusion: What Else Can Go Wrong?

Publication date: March 2018
Source:World Neurosurgery, Volume 111
Author(s): Elias Elias, Zeina Nasser, Lona Winegan, Terence Verla, Ibrahim Omeis
BackgroundBone morphogenetic protein (BMP) graft showed promising outcome during early phases of its use. However, unreported adverse events and off-label use shattered its safe profile and raised concerns regarding its indication. In 2008 the U.S. Food and Drug Administration prohibited its use in anterior cervical spine procedures due to the possibility of edema, hematoma, and need to intubate. At the molecular level, BMPs act as multifactorial growth factors playing a role in cartilage, heart, and bone formation. However, its unfavorable effect on bone overgrowth or heterotopic ossification post spine surgeries has been described. Reported cases in the literature were limited to epidural bone formation.Case DescriptionWe present a rare and interesting case of a 59-year-old female, in whom BMP caused intradural bone growth several years after an anterior lumbar interbody fusion surgery.ConclusionCaution must be exercised while using BMPs because of inadvertent complications.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2CHDmba