Bone Morphogenic Protein Is a Viable Adjunct for Fusion in Minimally Invasive Transforaminal Lumbar Interbody Fusion

• Published in: Asian spine journal Vol. 10; no. 6; pp. 1091 - 1099
• Main Authors: Siddiqui, M Mashfiqul Arafin, Sta Ana, Ana Rosario P, Yeo, William, Yue, Wai-Mun
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Spine Surgery 01.12.2016; Korean Spine Society; 대한척추외과학회
• Subjects: Back pain; Body mass index; Bone morphogenetic proteins; Bone morphogenic protein; Bone surgery; Clinical Study; Degenerative; Demographics; Fractures; Length of stay; Lumbar spine; Morphine; Pain; Patient satisfaction; Patients; Proteins; Skin & tissue grafts; Spine (lumbar); Surgeons; Surgery; TLIF BMP; Transforaminal interbody fusion; Trauma; X-rays; 정형외과학; United States > US; TLIF BMP; Degenerative; Lumbar spine; Transforaminal interbody fusion; Bone morphogenic protein
• ISSN: 1976-1902; 1976-7846
• DOI: 10.4184/asj.2016.10.6.1091

Comparison of prospectively collected data of patients undergoing minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) with and without recombinant human bone morphogenic protein 2 (BMP). To compare the clinical, radiological outcome and complications of patients undergoing MIS-TLIF with and without BMP. BMP is an effective fusion enhancer with potential complications. Direct comparison of MIS-TLIF with and without BMP is limited to retrospective studies with short follow-up. From June 2005 to February 2011, consecutive cases of MIS-TLIF performed by a single surgeon were included. North American Spine Society (NASS) score, Oswestry disability index (ODI), Short Form-36 (SF-36), and visual analogue score (VAS) were assessed preoperatively and at 6 and 24 months postoperatively. Fusion rates and complications were noted. The 252 cases comprised 104 non-BMP and 148 BMP cases. The BMP group was significantly older (mean age, 60.2 vs. 53.9; <0.01). Preoperative scores were similar. Immediate postoperative morphine usage was significantly lower in the BMP group (12.4 mg vs. 20.1 mg, <0.01). At 6 months, the BMP group had lower VAS back and leg pain scores ( <0.01). At 2 years, the BMP group had better leg pain scores ( <0.01), ODI (15.4 vs. 20.3, =0.04) and NASS scores (8.8 vs. 15.8, <0.01). Both groups showed significant clinical improvement compared to their preoperative levels. The BMP group attained a significantly higher rate of fusion at 6 months follow-up (88.4% vs. 76.8%, =0.016) with no difference at 2 years. The non-BMP and BMP group had 12 (11.5%) and 9 (6.1%) complications and 5 (4.8%) and 2 (1.4%) reoperations, respectively. The use of BMP to augment fusion in MIS-TLIF is an acceptable alternative that has potential benefits of less pain in early and intermediate postoperative follow-up.