Radiographic and CT Evaluation of Recombinant Human Bone Morphogenetic Protein-2-assisted Cervical Spinal Interbody Fusion

Luke J. Weisbrod, Paul M. Arnold, John D. Leever

Research output: Contribution to journalArticlepeer-review


STUDY DESIGN: This was a retrospective study. OBJECTIVE: To radiographically demonstrate the distinct fusion pattern of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the setting of anterior cervical discectomy and fusion. SUMMARY OF BACKGROUND DATA: Studies investigating spinal fusion assisted with rhBMP-2 have yielded promising results, suggesting rhBMP-2 is an efficacious alternative to iliac crest autografts. rhBMP-2-assisted spinal fusion both hastens healing and eliminates patient morbidity from iliac crest autograft. Unique to rhBMP-assisted spinal fusion is its distinct radiographic fusion pattern as fusion is achieved. Despite promising results and increased clinical use of rhBMP-2, there remains a paucity of literature documenting this radiographic process. MATERIALS AND METHODS: This study included 26 patients who underwent single-level anterior cervical discectomy and fusion using rhBMP-2. All data used for this study was collected from a prior FDA Investigational Device Exemption study. RESULTS: A polyetheretherketone cage was used as an interbody disk spacer in all 26 patients. Patients were evaluated between 2 and 6 weeks after surgery and subsequently at 3, 6, 12, and 24 months postoperative. All patients underwent plain radiography at every follow-up visit, and computed tomograhy evaluation was performed at 3, 6, 12, and 24 months as part of the study protocol. Earliest fusion was observed at 3 months in 38% of patients. Likely fusion was observed in all patients by 12 months postoperative. CONCLUSIONS: rhBMP-2 leads to both successful interbody fusion and an enhanced fusion rate with unique imaging characteristics. Additional characteristics of BMP observed in 100% of patients included prevertebral soft-tissue swelling and early endplate resorption. Other common features included polyetheretherketone cage migration, heterotopic bone formation and cage subsidence.

Original languageEnglish (US)
Pages (from-to)71-79
Number of pages9
JournalClinical spine surgery
Issue number2
StatePublished - Mar 1 2019
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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