BMP-2-induced Neuroforaminal Bone Growth in the Setting of a Minimally Invasive Transforaminal Lumbar Interbody Fusion. Issue 5 (June 2015)

• Record Type: Journal Article
• Authors: Ahn, Junyoung; Tabaraee, Ehsan; Singh, Kern
• Is Part Of: Journal of spinal disorders & techniques. Volume 28:Issue 5(2015)
• Publication Date: 2015-06
• Subjects: minimally invasive -- transforaminal -- lumbar fusion -- BMP -- bone growth; Spinal cord -- Diseases -- Periodicals; Spinal cord -- Surgery -- Periodicals; Spinal Diseases -- therapy -- Periodicals; Cordotomy -- methods -- Periodicals; Spinal Cord Diseases -- therapy -- Periodicals; Spinal Fusion -- methods -- Periodicals; Spine -- surgery -- Periodicals; 616.73
• DOI: 10.1097/BSD.0000000000000282
• Languages: English
• ISSNs: 1536-0652

Abstract

Abstract : Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has become a popular alternative to traditional methods of lumbar decompression and fusion. When compared with the open technique, the minimally invasive approach can result in decreased pain and blood loss as well as a shorter length of hospitalization. However, the narrower working channel through the tubular retractor increases the difficulty of decortication and bone grafting. Therefore, recombinant human bone morphogenetic proteins (rhBMP-2) is often utilized (although this is off-label) to create a more favorable interbody fusion environment. Recently, the use of rhBMP-2 has been associated with excessive bone growth in an MIS-TLIF. If this bone growth compresses the neighboring neural structures, patients may present with either new or recurrent radicular pain. Computed tomographic (CT) imaging can demonstrate heterotopic bone growth extending from the disk space into either the ipsilateral neuroforamen or lateral recess, which may result in the compression of the exiting or traversing root, respectively. The purpose of this article and the accompanying video is to demonstrate a technique for defining and resecting rhBMP-2-induced heterotopic bone growth following a previous MIS-TLIF. Abstract : Supplemental Digital Content is available in the text.