OBJECTIVE: There are several reports, which documented a high incidence of complications following the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in anterior cervical fusions (ACFs). The objective of this study is to share our experience with low-dose rhBMP-2 in anterior cervical spine. METHODS: We performed a retrospective analysis of 197 patients who underwent anterior cervical fusion (ACF) with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) during 2007-2012. A low-dose rhBMP-2 (0.7mg/level) sponge was placed exclusively within the cage. In 102 patients demineralized bone matrix (DBM) was filled around the BMP sponge. Incidence and severity of dysphagia was determined by 5 points SWAL-QOL scale. RESULTS: Two patients had prolonged hospitalization due to BMP unrelated causes. Following the discharge, 13.2%(n=26) patients developed dysphagia and 8.6%(n=17) patients complained of neck swelling. More than half of the patients (52.9%, n=9) with neck swelling also had associated dysphagia; however, only 2 of these patients necessitated readmission. Both of these patients responded well to the intravenous dexamethasone. The use of DBM did not affect the incidence and severity of complications (p>0.05). Clinico-radiological evidence of fusion was not observed in 2 patients. CONCLUSION: A low-dose rhBMP-2 in ACFs is not without risk. However, the incidence and severity of complications seem to be lower with low-dose BMP placed exclusively inside the cage. Packing DBM putty around the BMP sponge does not affect the safety profile of rhBMP-2 in ACFs.
OBJECTIVE: There are several reports, which documented a high incidence of complications following the use of recombinant humanbone morphogenetic protein-2 (rhBMP-2) in anterior cervical fusions (ACFs). The objective of this study is to share our experience with low-dose rhBMP-2 in anterior cervical spine. METHODS: We performed a retrospective analysis of 197 patients who underwent anterior cervical fusion (ACF) with the use of recombinant humanbone morphogenetic protein-2 (rhBMP-2) during 2007-2012. A low-dose rhBMP-2 (0.7mg/level) sponge was placed exclusively within the cage. In 102 patients demineralized bone matrix (DBM) was filled around the BMP sponge. Incidence and severity of dysphagia was determined by 5 points SWAL-QOL scale. RESULTS: Two patients had prolonged hospitalization due to BMP unrelated causes. Following the discharge, 13.2%(n=26) patients developed dysphagia and 8.6%(n=17) patients complained of neck swelling. More than half of the patients (52.9%, n=9) with neck swelling also had associated dysphagia; however, only 2 of these patients necessitated readmission. Both of these patients responded well to the intravenous dexamethasone. The use of DBM did not affect the incidence and severity of complications (p>0.05). Clinico-radiological evidence of fusion was not observed in 2 patients. CONCLUSION: A low-dose rhBMP-2 in ACFs is not without risk. However, the incidence and severity of complications seem to be lower with low-dose BMP placed exclusively inside the cage. Packing DBM putty around the BMP sponge does not affect the safety profile of rhBMP-2 in ACFs.
Authors: Lisa B E Shields; George H Raque; Steven D Glassman; Mitchell Campbell; Todd Vitaz; John Harpring; Christopher B Shields Journal: Spine (Phila Pa 1976) Date: 2006-03-01 Impact factor: 3.468
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Authors: Sravisht Iyer; Han Jo Kim; Hongda Bao; Justin S Smith; Themistocles S Protopsaltis; Gregory M Mundis; Peter Passias; Brian J Neuman; Eric O Klineberg; Virginie Lafage; Christopher P Ames Journal: Global Spine J Date: 2018-10-11
Authors: Benjamin C Mayo; Dustin H Massel; Daniel D Bohl; Dil V Patel; Benjamin Khechen; Brittany E Haws; Ankur S Narain; Fady Y Hijji; Kern Singh Journal: Int J Spine Surg Date: 2019-02-22