TY - JOUR
T1 - Complications associated with the use of the recombinant human bone morphogenetic proteins for posterior interbody fusions of the lumbar spine
AU - Chrastil, Jesse
AU - Low, Jeffrey B.
AU - Whang, Peter G.
AU - Patel, Alpesh A
PY - 2013/7/15
Y1 - 2013/7/15
N2 - STUDY DESIGN.: Systematic review. OBJECTIVE.: The objectives of this review are to examine the spectrum of complications that have been reported in the literature after posterior interbody fusions of the lumbar spine augmented with bone morphogenetic proteins (BMPs) and discuss potential methods for their prevention. SUMMARY OF BACKGROUND DATA.: The use of BMPs for spinal arthrodesis procedures has increased dramatically during the past decade. These products are commonly used in "off-label" fashion in posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) constructs. Recently, a number of adverse events have been attributed to the use of BMP for PLIF and TLIF surgical procedure, including heterotopic ossification within the epidural space or neuroforamina, postoperative radiculitis, and endplate osteolysis with interbody device subsidence. METHODS.: A computer aided literature search was performed on the electronic databases PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane Database of Systematic Reviews. Key words of interest included BMPs, PLIF, TLIF, complications, heterotopic ossification, radiculitis, and osteolysis. All articles, in the English language, between 1990 and 2011 were considered relating to the use of BMPs in PLIF and TLIF constructs. RESULTS.: Seventeen articles discussing the use and potential complications of BMPs in PLIF and TLIF constructs were identified and reviewed. The studies were in the range of a level I prospective randomized trial to case reports of complications. There is a wide variation of published complications associated with BMP-augmented PLIF and TLIF constructs. CONCLUSION.: Despite high fusion rates there is a growing body of evidence that the use of BMP in PLIF and TLIF constructs does not come without potential complication. There are appreciable rates of BMP-specific complications, which include heterotopic ossification within the epidural space or neuroforamina, postoperative radiculitis, and endplate osteolysis with interbody device subsidence.
AB - STUDY DESIGN.: Systematic review. OBJECTIVE.: The objectives of this review are to examine the spectrum of complications that have been reported in the literature after posterior interbody fusions of the lumbar spine augmented with bone morphogenetic proteins (BMPs) and discuss potential methods for their prevention. SUMMARY OF BACKGROUND DATA.: The use of BMPs for spinal arthrodesis procedures has increased dramatically during the past decade. These products are commonly used in "off-label" fashion in posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) constructs. Recently, a number of adverse events have been attributed to the use of BMP for PLIF and TLIF surgical procedure, including heterotopic ossification within the epidural space or neuroforamina, postoperative radiculitis, and endplate osteolysis with interbody device subsidence. METHODS.: A computer aided literature search was performed on the electronic databases PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane Database of Systematic Reviews. Key words of interest included BMPs, PLIF, TLIF, complications, heterotopic ossification, radiculitis, and osteolysis. All articles, in the English language, between 1990 and 2011 were considered relating to the use of BMPs in PLIF and TLIF constructs. RESULTS.: Seventeen articles discussing the use and potential complications of BMPs in PLIF and TLIF constructs were identified and reviewed. The studies were in the range of a level I prospective randomized trial to case reports of complications. There is a wide variation of published complications associated with BMP-augmented PLIF and TLIF constructs. CONCLUSION.: Despite high fusion rates there is a growing body of evidence that the use of BMP in PLIF and TLIF constructs does not come without potential complication. There are appreciable rates of BMP-specific complications, which include heterotopic ossification within the epidural space or neuroforamina, postoperative radiculitis, and endplate osteolysis with interbody device subsidence.
KW - BMP
KW - complication
KW - heterotopic ossifi cation
KW - HO
KW - osteolysis
KW - PLIF
KW - posterior interbody fusions
KW - posterior lumbar interbody fusion
KW - radiculitis
KW - recombinant human bone morphogenetic protein
KW - rhBMP
KW - subsidence
KW - TLIF
KW - transforaminal lumbar interbody fusion
UR - http://www.scopus.com/inward/record.url?scp=84880722847&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880722847&partnerID=8YFLogxK
U2 - 10.1097/BRS.0b013e3182982f8e
DO - 10.1097/BRS.0b013e3182982f8e
M3 - Review article
C2 - 23629484
AN - SCOPUS:84880722847
VL - 38
JO - Spine
JF - Spine
SN - 0362-2436
IS - 16
ER -