Use of recombinant human bone morphogenetic protein-2 to enhance posterior cervical spine fusion at 2 years of age: technical note.
BACKGROUND
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is a genetically engineered protein which recruits bone-forming cells to the surgical area and converts local cells to bone. In clinical studies, rhBMP-2 successfully enhanced anterior/posterior spinal fusions in adult humans without bone grafts. Efficacy in paediatric spinal fusion is not yet reported.


METHODS
We describe the surgical technique and results in a 2-year-old girl with unstable C1-2 cervical spine injury who underwent non-metal-instrumented C1/C2 posterior spinal fusion using rhBMP-2 applied to an absorbable collagen sponge (ACS) matrix.


RESULTS
Radiologically verifiable bony fusion began at 3 weeks. Within 8 weeks solid C1-C2 spinal fusion was confirmed by CT scan. There was no evidence of spinal canal encroachment and no adverse effects related to the rhBMP-2/ACS-carrier matrix.


CONCLUSIONS
rhBMP-2 enhanced posterior cervical fusion at an impressive rate in a very young child. This finding is encouraging both to effectiveness and speed. However, with all new developments, we highlight the need for further experience and longer follow-up in children.
Oluigbo
Chima O
CO
Department of Pediatric Neurosurgery, Birmingham Children's Hospital, Birmingham, UK.
Solanki
Guirish A
GA
D000367:Age Factors; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage* / Q000627:therapeutic use*; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D011994:Recombinant Proteins / Q000008:administration & dosage* / Q000627:therapeutic use*; D016103:Spinal Fractures / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016212:Transforming Growth Factor beta / Q000008:administration & dosage* / Q000627:therapeutic use*
D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2