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Observed features on imaging, attributed to the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in patients that underwent cervical fusion include: increased fusion rate, and incidence of swelling of prevertebral soft tissues.

Transforaminal lumbar interbody fusion_with rhBMP-2

The medical research study was conducted by Anil Sethi, Joseph Craig, Stephen Bartol, Wei Chen, Mark Jacobsen, Chad Coe and Rahul Vaidya from the Department of Orthopedics, Detroit Receiving Hospital; Department of Radiology and Department of Orthopedics (Henry Ford Hospital); Biostatistics Core, Karmanos Cancer Institute and Wayne State University School of Medicine, Detroit, MI.

The study is available in American Journal of Roentgenology. Bone morphogenetic proteins (BMP) when utilized in spinal fusion/spondylodesis – accelerate healing, and commence distinct imaging attributes. Through the study, researchers tried to register and assess the CT and radiographic alterations, after utilization of recombinant human bone morphogenetic protein 2 (rhBMP-2) in spine fusion surgery.

The study was comprised of about 95 patients that were made to pass through interbody spine fusion making use of recombinant human bone morphogenetic protein 2 (rhBMP-2) . Cohort study of lumbar spine fusion had 23 patients that passed through anterior lumbar interbody fusion (ALIF); 35 underwent transforaminal lumbar interbody fusion (TLIF), while 2 made to go through posterior lumbar interbody fusion. The residual, 34 patients were subjected to anterior cervical decompression and fusion (ACDF).

About the results, in 59 patients – polyetheretherketone (peek) cage was utilized as an interbody spacer, while for 36 patients – allograft bone worked as the spacer. The patients were assessed at various durations, after a slot of procedures, started initially with a gap of 2 and 6 weeks, and followed up to 3, 6, 12, 24 months, in respective order. All the patients were made to go through radiography follow-up examination, and computed tomography assessment was executed in 32 patients.

Conclusions: Attributed to the use of rhBMP-2, the imaging features observed included: increased fusion rate, and incidence of swelling of prevertebral soft tissues in patients that underwent cervical fusion. Endplate resorption was perceived in 100% of these patients that underwent cervical fusion, and in 82% of the lumbar levels. The gradual caving of the cage ensuing in disk space narrowing was observed in half of the cases. Heterotopic bone formation and cage migration in the neural foramen and spinal canal come out the maximum in the lumbar spine of patients that  had polyetheretherketone (peek) cage positioned through a transforaminal approach.