Vertebral osteolysis after posterior interbody lumbar fusion with recombinant human bone morphogenetic protein 2: a report of five cases.

摘要: Abstract Background Recombinant human bone morphogenetic protein 2 (rh-BMP-2) is frequently used in an off-label fashion. Its application for posterior interbody fusion appears intuitive because its use obviates the need iliac crest graft and shows higher rates than with of local autologous graft. To date, there no report adverse outcomes such rh-BMP-2. Purpose draw attention to this unusual complication lumbar review relevant literature. Study design Clinical five cases vertebral osteolysis that developed postoperatively from transforaminal L5/S1 motion segment using cages Methods Sixty-eight patients underwent spondylolisthesis or degenerative disc disease discogenic back pain. Five these 68 within 4 months their surgery. Their clinical presentation radiographic findings are presented case series. Results Each one had uneventful surgery postoperative recovery. leg pain improved immediate period. However, each patient reported worsening variable radicular as early weeks late 3 after index procedure. Diagnostic workup revealed evidence typically involving L5 body. In all patients, osteolytic defects filled spontaneously, symptoms resolved additional nonoperative care. Conclusions Vertebral can occur rh-BMP-2 fusions. Violation end plate during decortication may be a contributing factor. Symptoms often resolve spontaneously.