The Use of Bone Morphogenetic Protein in Lumbar Spine Surgery by Jeffrey A. Rihn, Charley Gates, Steven D. Glassman, Frank M. Phillips, James D. Schwender,

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Presentation transcript:

The Use of Bone Morphogenetic Protein in Lumbar Spine Surgery by Jeffrey A. Rihn, Charley Gates, Steven D. Glassman, Frank M. Phillips, James D. Schwender, and Todd J. Albert J Bone Joint Surg Am Volume 90(9): September 1, 2008 ©2008 by The Journal of Bone and Joint Surgery, Inc.

Axial (A), coronal (B), and sagittal (C) computed tomography images acquired twelve months after an L4-L5 posterolateral fusion with use of rhBMP-2. Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Intraoperative photograph demonstrating the approach for the transforaminal lumbar interbody fusion. Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

After the disc space is prepared, the BMP-soaked collagen sponge is packed into the interbody cage, and the cage is inserted into the anterior two-thirds of the disc space to maximize lordosis and minimize the risk of exposing the nerve root to BMP. Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Axial (A) and coronal (B) computed tomography scans demonstrating ectopic bone formation in the intervertebral foramen (white arrows) following a transforaminal lumbar interbody fusion performed with rhBMP-2. Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.

Coronal computed tomography scan (A) and sagittal T1-weighted magnetic resonance image (B) demonstrating vertebral osteolysis six months following a transforaminal lumbar interbody fusion performed with use of rhBMP-2. Jeffrey A. Rihn et al. J Bone Joint Surg Am 2008;90: ©2008 by The Journal of Bone and Joint Surgery, Inc.