Pseudo-Pedicle Heterotopic Ossification From Use of Recombinant Human Bone Morphogenetic Protein 2 (rhBMP-2) in Transforaminal Lumbar Interbody Fusion Cages.
Am J Orthop (Belle Mead NJ). 2018 Jan;47(1):
Authors: Rosen CD, Kiester PD, Lee TQ
We carried out a examine to find out the frequent traits of sufferers who developed radiculopathy signs and corresponding heterotopic ossification (HO) from transforaminal lumbar interbody fusions (TLIF) utilizing recombinant human bone morphogenetic protein 2 (rhBMP-2). HO can come up from a disk house with rhBMP-2 use in TLIF. Formation of bone round nerve roots or the thecal sac may cause a radiculopathy with a constant sample of signs. We recognized 38 sufferers (26 males, 12 females) with a imply (SD) age of 50.eight (7.5) years who developed radiculopathy signs and corresponding HO from TLIF with rhBMP-2 within the disk house between 2002 and 2015. To doc this complication and enhance its recognition, we recorded frequent patterns of symptom improvement and radiologic findings: particularly, time from implantation of rhBMP-2 to symptom improvement, consistency with aspect of TLIF placement, and radiologic findings. Radicular ache usually developed a imply (SD) of three.eight (1.zero) months after TLIF with rhBMP-2. Improvement of radiculopathy signs corresponded to constant “pseudo-pedicle”-like HO. In all 38 sufferers, HO arising from the annulotomy website confirmed a definite pseudo-pedicle sample encompassing nerve roots and the thecal sac. As well as, improvement of radiculopathy signs and corresponding HO seem like unbiased of quantity of rhBMP-2. HO ensuing from TLIF with rhBMP-2 within the disk house is a ache generator and a recognizable complication that may be identified by evaluation of signs and computed tomography traits.
PMID: 29447305 [PubMed – in process]