Complications of Anterior Cervical Fusion using a Low-dose Recombinant Human Bone Morphogenetic Protein-2.
10.14245/kjs.2015.12.2.68
- Author:
Sunil KUKREJA
1
;
Osama I AHMED
;
Justin HAYDEL
;
Anil NANDA
;
Anthony H SIN
Author Information
1. Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA. asin@lsuhsc.edu
- Publication Type:Original Article
- Keywords:
Anterior cervical fusion;
rhBMP-2;
Complications;
Dose;
Delivery methods
- MeSH:
Bone Matrix;
Deglutition Disorders;
Dexamethasone;
Hospitalization;
Humans;
Incidence;
Neck;
Porifera;
Retrospective Studies;
Spine
- From:Korean Journal of Spine
2015;12(2):68-74
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
