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in reply to: Expandable TLIF cage #22541
That makes sense in the disc space, however does the above also refer to issues using BMP with posterolateral fusion. i.e. neuroforaminal complication ?
in reply to: Expandable TLIF cage #22523Just came across this on the internet….can you please elaborate ?
NERVE ROOT INJURIES DUE TO BONE
MORPHOGENETIC PROTEIN IN LUMBAR
FUSIONS
Several studies now document that the application
of recombinant human BMP‑2 (rhBMP‑2) in lumbar
fusion procedures can produce neural injury not only
documented clinically, but also histopathologically.[3,9,21]
Dmitriev et al., in their 2011 article, demonstrated the
significant negative impact of applying rhBMP‑2 near
neural structures.[9] In another study, Corenman et al.
retrospectively evaluated the results of TLIF performed
with BMP-2 for patients with discogenic pain syndromes;
11 (30.6%) patients exhibited unexplained postoperative
radiculitis, whereas 4 needed additional surgery
[Table 2].[3] In the review article by Tannoury and An in
2014, they noted that rhBMP‑2 resulted in adverse events
including nerve root injury/radiculitis when utilized to
perform cervical or lumbar fusions.[21] Although all of
these authors cite “real concerns” about the off‑label use
of BMP in spinal surgery, where is the momentum to
remove this product from the shelves?
Financial support and sponsorshipin reply to: Expandable TLIF cage #22509Thank you !
in reply to: Expandable TLIF cage #22489I know you research MIS TLIF.
There are reports of neuroforaminal bone growth from just putting BMP in the cage within the disc space; unless I am reading this wrong.
How is this possible to have radiculopathy and neroformanial bone growth after MIS TLIF with BMP ?
MIS TLIF has no posterolateral fusion.
in reply to: Expandable TLIF cage #22487sorry for all the questions. I am researching use of BMP with MIS TLIF and have come across a few cases with
neuroforaminal overgrowth.1.) How is this possible to have radiculopathy and neroformanial bone growth after MIS TLIF with BMP vs. Open TLIF with BMP, especially when BMP is used on the non TLIF side with open TLIF ? MIS TLIF has not posterolateral fusion.
2.) Where is the BMP placed in MIS TLIF ? In the cage, in front of cage ?
3.) Aren’t there bone chips packed in the disc space to protect the BMP from growing out with either surgery ?
Thank you!
in reply to: Severe calf muscle cramping post op L5-S1 fusion.. #22389Thank you.
I can tell you that after vetting fusion surgery for isthmic spondylolisthesis you are one of the very few that understands it thoroughly. While it is true that other surgeons understand TLIF for isthmic spondy conceptually their approach to the surgery is not as maticulous as yours. I believe the minute details of the surgery are what makes the difference in recovery.
For example, may surgeons have told me that using BMP is only reserved for revision surgery. I question if many of them know how to use BMP it all. You use it on the non TLIF side. Most use it on both sides. This can be dangeous, correct ?
Last, many surgeons insist there are no bone spurs with a par fracture. This is blatantly wrong. I can see my own bone spurs on my ct scan and yes distracting the disc space with an ALIF can leave you with more pain after surgery.
Anyway, this is a very convoluted diagnosis. I greatly appreciate you helping me understand it. It helps in the decision making process. You are the best !
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