title: The use of recombinant human BMP-2 as a salvage procedure in the pediatric spine: a report on 3 cases.
abstract: The study is a retrospective case series. The objective is to review the results after off-label recombinant human BMP-2 (rhBMP-2) use in the pediatric spine after previously failed spinal fusion. Non-union in the pediatric spine is a challenging condition associated with increased morbidity due to instability, neurological impairment or multiple revision surgeries. BMP has been used with good results in the adult spine; however, information on its use in the pediatric population is still lacking. rhBMP-2 was used at our institution at revision posterior spinal surgery in three patients. Solid spinal fusion was achieved in all three cases despite underlying bone dysplasia (Hurler's disease), instability or bony substance loss. No adverse reactions due to rhBMP-2 use were observed. rhBMP-2 should be considered as potential option to achieve spinal fusion in children with compromised bone healing due to congenital, local or systemic conditions.
authors.affiliation: Department of Pediatric Orthopedic Surgery, Altonaer Children's Hospital, Bleickenallee 38, 22763 Hamburg, Germany. mladenow_kiril@yahoo.com
authors.forename: Kiril V
authors.initials: KV
authors.lastname: Mladenov
authors.forename: Philip
authors.initials: P
authors.lastname: Kunkel
authors.forename: Ralf
authors.initials: R
authors.lastname: Stuecker
mesh_terms: D000367:Age Factors; D055396:Bone Morphogenetic Protein 2 / Q000494:pharmacology* / Q000627:therapeutic use; D001861:Bone Regeneration / Q000187:drug effects* / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D011993:Recombinant Fusion Proteins / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects*; D013131:Spine / Q000254:growth & development / Q000473:pathology / Q000601:surgery; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D011993:Recombinant Fusion Proteins