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Safety, efficacy, and dosing of recombinant human bone morphogenetic protein-2 for posterior cervical and cervicothoracic instrumented fusion with a minimum 2-year follow-up.

Publication ,  Journal Article
Hamilton, DK; Smith, JS; Reames, DL; Williams, BJ; Chernavvsky, DR; Shaffrey, CI
Published in: Neurosurgery
July 2011

BACKGROUND: Considerable attention has focused on concerns of increased complications with recombinant human bone morphogenetic protein-2 (rhBMP-2) use for anterior cervical fusion, but few reports have assessed its use for posterior cervical fusions. OBJECTIVE: To assess the safety, efficacy, and dosing of rhBMP-2 as an adjunct for instrumented posterior cervical arthrodesis. METHODS: All patients treated by the senior author with posterior cervical or cervicothoracic instrumented fusion using rhBMP-2 from 2003 to 2008 with a minimum of 2 years of follow-up were included. Diagnosis, levels fused, rhBMP-2 dose, complications, and fusion were assessed. RESULTS: Fifty-three patients with a mean age of 55.7 years (range, 2-89 years) and an average follow-up of 40 months (range, 25-80 months) met inclusion criteria. Surgical indications included basilar invagination (n = 6), fracture (n = 6), atlantoaxial instability (n = 16), kyphosis/kyphoscoliosis (n = 22), osteomyelitis (n = 1), spondylolisthesis (n = 1), and cyst (n = 1). Fifteen patients had confirmed rheumatoid disease. The average rhBMP-2 dose was 1.8 mg per level, with a total of 282 levels treated (average, 5.3 levels; SD, 2.8 levels). Among 53 patients, only 2 complications (3.8%) were identified: a superficial wound infection and an adjacent-level degeneration. No cases of dysphagia or neck swelling requiring treatment were identified. At the last follow-up, all patients had achieved fusion. CONCLUSION: Despite many of the patients in the present series having complex pathology and/or rheumatoid arthritis, a 100% fusion rate was achieved. Collectively, these data suggest that use of rhBMP-2 as an adjunct for posterior cervical fusion is safe and effective at an average dose of 1.8 mg per level.

Duke Scholars

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

July 2011

Volume

69

Issue

1

Start / End Page

103 / 111

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transforming Growth Factor beta
  • Tomography, X-Ray Computed
  • Spinal Fusion
  • Spinal Cord Diseases
  • Retrospective Studies
  • Recombinant Proteins
  • Neurology & Neurosurgery
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hamilton, D. K., Smith, J. S., Reames, D. L., Williams, B. J., Chernavvsky, D. R., & Shaffrey, C. I. (2011). Safety, efficacy, and dosing of recombinant human bone morphogenetic protein-2 for posterior cervical and cervicothoracic instrumented fusion with a minimum 2-year follow-up. Neurosurgery, 69(1), 103–111. https://doi.org/10.1227/NEU.0b013e318214a9b1
Hamilton, D Kojo, Justin S. Smith, Davis L. Reames, Brian J. Williams, Daniel R. Chernavvsky, and Christopher I. Shaffrey. “Safety, efficacy, and dosing of recombinant human bone morphogenetic protein-2 for posterior cervical and cervicothoracic instrumented fusion with a minimum 2-year follow-up.Neurosurgery 69, no. 1 (July 2011): 103–11. https://doi.org/10.1227/NEU.0b013e318214a9b1.
Hamilton, D. Kojo, et al. “Safety, efficacy, and dosing of recombinant human bone morphogenetic protein-2 for posterior cervical and cervicothoracic instrumented fusion with a minimum 2-year follow-up.Neurosurgery, vol. 69, no. 1, July 2011, pp. 103–11. Pubmed, doi:10.1227/NEU.0b013e318214a9b1.
Hamilton DK, Smith JS, Reames DL, Williams BJ, Chernavvsky DR, Shaffrey CI. Safety, efficacy, and dosing of recombinant human bone morphogenetic protein-2 for posterior cervical and cervicothoracic instrumented fusion with a minimum 2-year follow-up. Neurosurgery. 2011 Jul;69(1):103–111.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

July 2011

Volume

69

Issue

1

Start / End Page

103 / 111

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transforming Growth Factor beta
  • Tomography, X-Ray Computed
  • Spinal Fusion
  • Spinal Cord Diseases
  • Retrospective Studies
  • Recombinant Proteins
  • Neurology & Neurosurgery
  • Middle Aged