BMP 2 usage in posterior lumbar fusion in degenerative conditions
Abstract rhBMP 2 is approved for use in single level anterior lumbar interbody fusion (ALIF) within an LT CAGE. Following impressive reports regarding the safety and efficacy of rhBMP 2 in ALIF, many surgeons have started using rhBMP 2 as a graft substitute for posterior lumbar fusion in an off label manner. A number of studies have been published documenting the outcomes and complications seen following the off label use of rhBMP 2 in the lumbar spine. In the setting of PLF, PLIF, and TLIF, fusion rates following the administration of rhBMP 2 are comparable, and at times, higher than the fusion rates seen with ICBG. rhBMP 2 is frequently associated with decreased blood loss and faster operative times as compared to ICBG. Radiculitis, osteolysis, and ectopic bone formation are adverse events seen related to the use of rhBMP 2 in PLIF and TLIF.