[Donald Corenman, MD, DC]

#17742

Using cadaver bone for a PLIF has a long history. It is not a bad idea as the donor bone is biologically active and should incorporate as part of the fusion. BMP is also a good idea as this hormone induces your own stem cells to turn into bone cells. I think his process for fusion is acceptable.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[biofreeze]

#17769

Thank you.

IS the Cadaver bone filled with bone from laminectomy or is just solid bone cut in the shape of a PLIF cage ?

Will the cadaver bone take longer to fuse that regular bone, I want to fuse as quickly as possible ?

Also, I read on your website that when you place BMP in the front to “speed” up fusion that you shield it with the TLIF cage from the rest of the disc space and Dura. Will this be an issue PLIF being that there is these two cages ?

Last, you also have on your website that BNP has been associated with cancer risk, but without much supporting evidence. Will a low dose of BNP in front of spine be able to travel throughout the body ? There seems to be lot of people out of there on specific blogs that claim they were given BNP and developed benign tumors and other masses 3 years after surgery !

Thank you again !

[Donald Corenman, MD, DC]

#18076

There are various donor bone cages, some with a hollowed out area for the patient’s own bone and some with the natural cancellous bone from the donor in the central region. The BMP I mix with the patient’s own bone to create a “slurry” that is placed in the front of the disc space. I then place an “inert” graft material called “mastergraft” behind that slurry and finally the PEEK cage filled with autograft (the patient’s own bone) in the rear of the disc space.

The PLIF can be performed the same way with the above noted techniques.

I have found no correlation between BMP and cancer risk. There are confilcting studies published with some actually noting decreased cancer risk. The BMP actually lasts only two weeks before it is washed out of the body. I would use this protein on myself.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[biofreeze]

#18077

This is extremely helpful information. Thank you.

What dose of BNP do you use for TLIF vs. the typical dose for ALIF ?

Would it be considered any safer to use if it were placed in the ALIF cage and stays contained in between the vertebrae ? Is the alleged fear that it will get absorbed in blood stream if it is not compressed in a cage ?

Why is BNP approved for ALIF, but is off label for TLIF ?

Based on what I have read, there does appear to be confirmation that BNP that can exacerbate benign tumors by 33% within three years of surgery, although I believe that was at higher doses.

[Donald Corenman, MD, DC]

#18086

I use BMP at a dose of 1.5 mg in the disc space and 4-6 mg on the opposite side of the TLIF. The problem with BMP is it is inflammatory and can cause nerve root irritation. It needs to be shielded from the nerve root.

BMP is approved for the ALIF due to the initial study by Zedeblik.

I would disagree with the benign tumor exaserbation comment. I have used this for about 8 years and have never seen this possibility. You might be looking at the old study with the use of BMP at at least 14 times the current dose used at each level.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[biofreeze]

#18089

I am so sincerely grateful for your explanation !

You said you put 4-6 mg BNP on opposite side of TLIF….where? In the opposite gutter ?

Would you happen to know the typical dose that goes into an ALIF cage ?

Will the solid cadaver PLIF bone take much longer to fuse than that of a peek PLIF cage filled with autograft bone ?

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