Evaluation of Heterotopic Ossification After Using Recombinant Human Bone Morphogenetic Protein-2 in Transforaminal Lumbar Interbody Fusion: A Computed Tomography Review of 996 Disc Levels.

Autor:	Niu S; Emory University School of Medicine, Atlanta, GA, USA., Anastasio AT; Emory University School of Medicine, Atlanta, GA, USA., Faraj RR; Emory University School of Medicine, Atlanta, GA, USA., Rhee JM; Emory University School of Medicine, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2020 May; Vol. 10 (3), pp. 280-285. Date of Electronic Publication: 2019 May 01.
DOI:	10.1177/2192568219846074
Abstrakt:	Study Design: Retrospective cohort study. Objectives: Reported incidences and complications of heterotopic ossification (HO) after using recombinant human bone morphogenetic protein-2 (rhBMP-2) in transforaminal lumbar interbody fusion (TLIF) have been inconclusive. This study was designed to evaluate both incidences of radiologic and symptomatic HO in a large series of TLIFs using rhBMP-2. Methods: A total of 996 disc levels in 927 consecutive TLIF patients were retrospectively evaluated at 6-month postoperative follow-up in a single surgical practice. Subjects were separated into the BMP group and the control group. Operative reports, pre- and postoperative medical records were reviewed. Computed tomography (CT) scans were analyzed and graded independently for ossification at each disc level of TLIF. Results: A total of 933 disc levels were in the BMP group, and 63 were in the control group. Six-month fusion rate of interbody was 92.5% in the BMP group, which was significantly higher in contrast to 71.4% in the control group ( P < .001). The incidence of radiologic HO in the BMP group was 13.5%, which was significantly higher than 1.6% in the control group ( P = .006). After controlling for basic demographics and comorbidities, the presence of radiologic HO was significantly associated with the use of rhBMP-2 ( P = .026). However, only one case in the BMP group (0.11%) developed a symptomatic HO (mild-medium left buttock pain, treated nonsurgically) involving left foramen of L5-S1. Conclusions: rhBMP-2 can be safely used in TLIF with regard to HO. There was a low rate of radiologic HO and minimal symptomatic HO, with high fusion rates at 6 months postoperative. Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: John M. Rhee, MD: Dr. Rhee reports personal fees from Medtronic, personal fees from Stryker spine, personal fees from Biomet Spine, personal fees from Zimmer, personal fees from Wolters-Kluwer, outside the submitted work. (© The Author(s) 2019.)
Databáze:	MEDLINE
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