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

Lewandrowski, Kai‐Uwe; Nanson, Christopher J.; Calderon, Robert

doi:10.1016/j.spinee.2007.01.011

Cited by 157 publications

(85 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8][9][10]34 Therefore, an appropriate delivery system for reducing the dose of BMP-2 for bone regeneration is required. Recent studies have mainly focused on organic, inorganic, and synthetic carrier scaffolds.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 However, high dosages of BMP-2 increase the cost of treatment and also cause unexpected serious complications, including ectopic new bone formation, osteolysis, excessive immune responses, postoperative neurological impairment, and compromised airways. [8][9][10] Therefore, novel methods for reducing the dose of BMP-2 are needed to prevent the occurrence or reduce the severity of these adverse effects.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dose reduction of bone morphogenetic protein-2 for bone regeneration using a delivery system based on lyophilization with trehalose

Zhang¹,

Yu²,

Wang³

et al. 2018

IJN

View full text Add to dashboard Cite

Introduction To induce sufficient new bone formation, high doses of bone morphogenetic protein-2 (BMP-2) are applied in regenerative medicine that often induce serious side effects. Therefore, improved treatment strategies are required. Here, we investigate whether the delivery of BMP-2 lyophilized in the presence of trehalose reduced the dose of BMP-2 required for bone regeneration. Materials and methods A new growth factor delivery system was fabricated using BMP-2-loaded TiO 2 nanotubes by lyophilization with trehalose (TiO 2 -Lyo-Tre-BMP-2). We measured BMP-2 release characteristics, bioactivity, and stability, and determined the effects on the osteogenic differentiation of bone marrow stromal cells in vitro. Additionally, we evaluated the ability of this formulation to regenerate new bone around implants in rat femur defects by micro-computed tomography (micro-CT), sequential fluorescent labelling, and histological analysis. Results Compared with absorbed BMP-2-loaded TiO 2 nanotubes (TiO 2 -BMP-2), TiO 2 -Lyo-Tre-BMP-2 exhibited sustained release, consistent bioactivity, and higher stability of BMP-2, and resulted in greater osteogenic differentiation of BMSCs. Eight weeks post-operation, TiO 2 -Lyo-Tre-BMP-2 nanotubes, with various dosages of BMP-2, regenerated larger amounts of new bone than TiO 2 -BMP-2 nanotubes. Conclusion Our findings indicate that delivery of BMP-2 lyophilized with trehalose may be a promising method to reduce the dose of BMP-2 and avoid the associated side effects.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dose reduction of bone morphogenetic protein-2 for bone regeneration using a delivery system based on lyophilization with trehalose

Zhang¹,

Yu²,

Wang³

et al. 2018

IJN

View full text Add to dashboard Cite

show abstract

“…46 Although the off-label use of BMP for spine has met with radiographic and clinical success, concern has been raised due to reports of rare but significant neurological or structural complications following the use of BMPs, particularly with interbody fusions. 42,50 In addition, whether the routine use of BMPs is cost-effective has yet to be demonstrated. This uncertainty requires a careful evaluation of the literature investigating the various applications of the available BMPs.…”

Section: Bone Morphogenetic Proteinsmentioning

confidence: 99%

“…47 Lewandrowski et al observed osteolysis of the vertebral endplate following minimally invasive TLIF and speculated that endplate violation during interbody decortication may have been a contributing factor. 42 Although not specific for lumbar procedures, Vaidya et al observed a higher incidence of graft subsidence when rhBMP-2 was used with an allograft interbody spacer. 66 Joseph and Rampersaud observed a greater incidence of heterotopic bone formation following the use of rhBMP-2 for minimal access interbody lumbar fusion, but no clinical sequelae associated with this excessive bone formation were identified.…”

Section: Singh Et Al 2006 IIImentioning

confidence: 99%

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: Bone graft extenders and substitutes as an adjunct for lumbar fusion

Kaiser

Groff

Watters

et al. 2014

SPI

View full text Add to dashboard Cite

In an attempt to enhance the potential to achieve a solid arthrodesis and avoid the morbidity of harvesting autologous iliac crest bone (AICB) for a lumbar fusion, numerous alternatives have been investigated. The use of these fusion adjuncts has become routine despite a lack of convincing evidence demonstrating a benefit to justify added costs or potential harm. Potential alternatives to AICB include locally harvested autograft, calcium-phosphate salts, demineralized bone matrix (DBM), and the family of bone morphogenetic proteins (BMPs). In particular, no option has created greater controversy than the BMPs. A significant increase in the number of publications, particularly with respect to the BMPs, has taken place since the release of the original guidelines. Both DBM and the calciumphosphate salts have demonstrated efficacy as a graft extender or as a substitute for AICB when combined with local autograft. The use of recombinant human BMP-2 (rhBMP-2) as a substitute for AICB, when performing an interbody lumbar fusion, is considered an option since similar outcomes have been observed; however, the potential for heterotopic bone formation is a concern. The use of rhBMP-2, when combined with calcium phosphates, as a substitute for AICB, or as an extender, when used with local autograft or AICB, is also considered an option as similar fusion rates and clinical outcomes have been observed. Surgeons electing to use BMPs should be aware of a growing body of literature demonstrating unique complications associated with the use of BMPs.

show abstract

“…including an increased risk of retrograde ejaculation after anterior lumbar interbody fusion, 2,6,23 osteolysis and subsidence, 17,19,20,25,26 ectopic bone formation and an increased risk of radiculitis, 14,16,28 infection, 27 a higher reoperation rate, 28 and potential risk of developing cancer. 12 Three population-based studies provided contrary data.…”

mentioning

confidence: 99%

A population-based review of bone morphogenetic protein: associated complication and reoperation rates after lumbar spinal fusion

Savage

Kelly

Ellison³

et al. 2015

FOC

View full text Add to dashboard Cite

OBJECT The authors compared the rates of postoperative adverse events and reoperation of patients who underwent lumbar spinal fusion with bone morphogenetic protein (BMP) to those of patients who underwent lumbar spinal fusion without BMP. METHODS The authors retrospectively analyzed the PearlDiver Technologies, Inc., database, which contains the Medicare Standard Analytical Files, the Medicare Carrier Files, the PearlDiver Private Payer Database (UnitedHealthcare), and select state all-payer data sets, from 2005 to 2010. They identified patients who underwent lumbar spinal fusion with and without BMP. The ICD-9-CM code 84.52 was used to identify patients who underwent spinal fusion with BMP. ICD-9-CM diagnosis codes identified complications that occurred during the initial hospital stay. ICD-9-CM procedural codes were used to identify reoperations within 90 days of the index procedure. The relative risks (and 95% CIs) of BMP use compared with no BMP use (control) were calculated for the association of any complication with BMP use compared with the control. RESULTS Between 2005 and 2010, 460,773 patients who underwent lumbar spinal fusion were identified. BMP was used in 30.7% of these patients. The overall complication rate in the BMP group was 18.2% compared with 18.7% in the control group. The relative risk of BMP use compared with no BMP use was 0.976 (95% CI 0.963–0.989), which indicates a significantly lower overall complication rate in the BMP group (p < 0.001). In both treatment groups, patients older than 65 years had a statistically significant higher rate of postoperative complications than younger patients (p < 0.001). CONCLUSIONS In this large-scale institutionalized database study, BMP use did not seem to increase the overall risk of developing a postoperative complication after lumbar spinal fusion surgery.

show abstract

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

Cited by 157 publications

References 10 publications

Dose reduction of bone morphogenetic protein-2 for bone regeneration using a delivery system based on lyophilization with trehalose

Dose reduction of bone morphogenetic protein-2 for bone regeneration using a delivery system based on lyophilization with trehalose

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: Bone graft extenders and substitutes as an adjunct for lumbar fusion

A population-based review of bone morphogenetic protein: associated complication and reoperation rates after lumbar spinal fusion

Contact Info

Product

Resources

About