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Predictive factors and rates of fusion in minimally invasive transforaminal lumbar interbody fusion utilizing rhBMP-2 or mesenchymal stem cells

Publication ,  Journal Article
Overley, SC; McAnany, SJ; Anwar, MA; Merrill, RK; Lovy, A; Guzman, JZ; Zhadanov, S; Doshi, A; Rothenberg, E; Vaishnav, A; Gang, C; Qureshi, SA
Published in: International Journal of Spine Surgery
January 1, 2019

Background: Several fusion adjuncts exist to enhance fusion rates during minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). The objective of this study was to compare fusion rates in patients undergoing MI-TLIF with either rhBMP-2 or cellularized bone matrix (CBM). Methods: We conducted a single surgeon retrospective cohort study of patients who underwent MI-TLIF with either rhBMP-2 or CBM placed in an interbody cage. Single and multilevel procedures were included. Fusion was assessed on computed tomography scans at 12-month follow-up by an independent, blinded, board-certified neuroradiologist. Fusion rates and rate of revision surgery were compared with a Fisher exact test between the 2 groups. A multivariate regression analysis was performed to identify patient factors that were predictive of radiographic nonunion after MI-TLIF. Results: A total of 93 fusion levels in 78 patients were reviewed. Thirty-nine patients received CBM, and 39 patients received rhBMP-2. The patients receiving rhBMP-2 were older on average (61.4 vs 55.6, P = .03). The overall fusion rate was 68% in the CBM group (32/47 levels) and 78% in the rhBMP-2 group (36/46) (P = .35). Only preoperative hypertension was predictive of radiographic nonunion (odds ratio = 3.5, P = .05). There were 3 smokers in the CBM group and 4 smokers in the BMP group, and 1 in each group experienced radiographic pseudarthrosis. A total of 4 patients, 3 in the CBM group and 1 in the BMP group (P = .61), required revision for symptomatic pseudarthrosis. All of these patients had a single-level index procedure. Conclusions: There were no differences in radiographic fusion and rate of revision surgery in patients who underwent MI-TLIF with either rhBMP-2 or CBM as fusion adjuncts. Level of Evidence: 3 Clinical Relevance: Both rhBMP-2 and CBMs can be used as effective fusion adjuncts without any clear advantage of one over the other.

Duke Scholars

Published In

International Journal of Spine Surgery

DOI

EISSN

2211-4599

Publication Date

January 1, 2019

Volume

13

Issue

1

Start / End Page

46 / 52

Related Subject Headings

  • 3202 Clinical sciences
  • 1109 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Overley, S. C., McAnany, S. J., Anwar, M. A., Merrill, R. K., Lovy, A., Guzman, J. Z., … Qureshi, S. A. (2019). Predictive factors and rates of fusion in minimally invasive transforaminal lumbar interbody fusion utilizing rhBMP-2 or mesenchymal stem cells. International Journal of Spine Surgery, 13(1), 46–52. https://doi.org/10.14444/6007
Overley, S. C., S. J. McAnany, M. A. Anwar, R. K. Merrill, A. Lovy, J. Z. Guzman, S. Zhadanov, et al. “Predictive factors and rates of fusion in minimally invasive transforaminal lumbar interbody fusion utilizing rhBMP-2 or mesenchymal stem cells.” International Journal of Spine Surgery 13, no. 1 (January 1, 2019): 46–52. https://doi.org/10.14444/6007.
Overley SC, McAnany SJ, Anwar MA, Merrill RK, Lovy A, Guzman JZ, et al. Predictive factors and rates of fusion in minimally invasive transforaminal lumbar interbody fusion utilizing rhBMP-2 or mesenchymal stem cells. International Journal of Spine Surgery. 2019 Jan 1;13(1):46–52.
Overley, S. C., et al. “Predictive factors and rates of fusion in minimally invasive transforaminal lumbar interbody fusion utilizing rhBMP-2 or mesenchymal stem cells.” International Journal of Spine Surgery, vol. 13, no. 1, Jan. 2019, pp. 46–52. Scopus, doi:10.14444/6007.
Overley SC, McAnany SJ, Anwar MA, Merrill RK, Lovy A, Guzman JZ, Zhadanov S, Doshi A, Rothenberg E, Vaishnav A, Gang C, Qureshi SA. Predictive factors and rates of fusion in minimally invasive transforaminal lumbar interbody fusion utilizing rhBMP-2 or mesenchymal stem cells. International Journal of Spine Surgery. 2019 Jan 1;13(1):46–52.
Journal cover image

Published In

International Journal of Spine Surgery

DOI

EISSN

2211-4599

Publication Date

January 1, 2019

Volume

13

Issue

1

Start / End Page

46 / 52

Related Subject Headings

  • 3202 Clinical sciences
  • 1109 Neurosciences