Complications of Anterior Cervical Fusion using a Low-dose Recombinant Human Bone Morphogenetic Protein-2

Sunil Kukreja; Osama I Ahmed; Justin Haydel; Anil Nanda; Anthony H Sin

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자료유형: 학술저널

저자정보: Sunil Kukreja (Louisiana State University USA) Osama I Ahmed (Louisiana State University USA) Justin Haydel (Louisiana State University USA) Anil Nanda (Louisiana State University USA) Anthony H Sin (Louisiana State University USA)

저널정보: 대한척추신경외과학회 Neurospine 대한척추신경외과학회지 제12권 제2호

발행연도: 2015.1

수록면: 68 - 74 (7page)

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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.

참고문헌 (15)

참고문헌 신청

Baskin DS. / 2003 / A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate / Spine(Phila Pa 1976) 28:1219~1224

Boakye M. / 2005 / Anterior cervical discectomy and fusion involving a polyetheretherketone spacer and bone morphogenetic protein / J Neurosurg Spine 2:521~525

Buttermann GR. / 2008 / Prospective nonrandomized comparison of an allograft with bone morphogenic protein versus an iliac-crest autograft in anterior cervical discectomy and fusion / Spine J 8:426~435

Dickerman RD. / 2007 / rh-BMP-2 can be used safely in the cervical spine : dose and containment are the keys / Spine J 7:508~509

Lanman TH. / 2004 / Early findings in a pilot study of anterior cervical interbody fusion in which recombinant human bone morphogenetic protein-2 was used with poly(L-lactideco-D, Llactide)bioabsorbable implants / Neurosurg Focus 16:E6

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