title: Ectopic bone formation with joint impingement after posterior lumbar fusion with rhBMP-2.
abstract: Recombinant human bone morphogenetic protein-2 (rhBMP-2) was recently licensed for local administration during posterior lumbar fusion. In this indication, considerable uncertainty remains about the nature and mechanisms of the many adverse effects of rhBMP-2, such as ectopic bone formation. We report a case of ectopic bone formation with impingement on a facet joint and incapacitating low back pain after minimally invasive transforaminal L5-S1 interbody fusion with local application of rhBMP-2 (InductOs(®)). Revision surgery was eventually performed to alleviate the symptoms by removing the ectopic bone. Caution is in order regarding the use of rhBMP-2 during posterior lumbar fusion. Every effort should be made to minimise the risk of complications.
authors.affiliation: Neurosurgery department, Reims University Hospital, Reims, France. Electronic address: mathieu.bannwarth@neurochirurgie.fr.
authors.forename: M
authors.initials: M
authors.lastname: Bannwarth
authors.affiliation: Neurosurgery department, Reims University Hospital, Reims, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Kleiber
authors.affiliation: Neurosurgery department, Reims University Hospital, Reims, France.
authors.forename: B
authors.initials: B
authors.lastname: Marlier
authors.affiliation: Neurosurgery department, Reims University Hospital, Reims, France.
authors.forename: C
authors.initials: C
authors.lastname: Eap
authors.affiliation: Neurosurgery department, Reims University Hospital, Reims, France.
authors.forename: J
authors.initials: J
authors.lastname: Duntze
authors.affiliation: Neurosurgery department, Reims University Hospital, Reims, France.
authors.forename: C F
authors.initials: CF
authors.lastname: Litre
mesh_terms: D000328:Adult; D055396:Bone Morphogenetic Protein 2 / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae; D009999:Ossification, Heterotopic / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D011994:Recombinant Proteins / Q000009:adverse effects; D012086:Reoperation; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D016212:Transforming Growth Factor beta / Q000009:adverse effects*
chemical_list: D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2
keywords: Complications; Recombinant human bone morphogenetic protein-2; Spinal fusion