Bone Morphogenetic Proteins Usage in Anterior Lumbar Inter-Body Fusion: What Else Can Go Wrong?

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Bone Morphogenetic Proteins Usage in Anterior Lumbar Inter-Body Fusion: What Else Can Go Wrong?

World Neurosurg. 2017 Dec 08;:

Authors: Elias E, Nasser Z, Winegan L, Verla T, Omeis I

Abstract
BACKGROUND: Bone Morphogenetic Protein (BMP) graft showed promising outcome during early phases of its use. However unreported adverse events and off label use shattered its safe profile and raised concerns regarding its indication. In 2008, the Food and Drug Administration (FDA) prohibited its use in anterior cervical spine procedures due to possibility of edema, hematoma and need of intubation. At the molecular level, BMP act as multifactorial growth factors playing a role in cartilage, heart, and bone formation. However its unfavorable effect on bone overgrowth or heterotopic ossification post spine surgeries has been described. Reported cases in literature were limited to epidural bone formation.
CASE DESCRIPTION: We present a rare and interesting case of a 59 year old female, where BMP caused intra-Dural bone growth several years after an anterior lumbar inter-body fusion (ALIF) surgery.
CONCLUSION: Caution must be exercised while using BMP because of inadvertent complications .

PMID: 29229348 [PubMed - as supplied by publisher]

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