Question:I was in a car accident 10-years ago and hurt both my neck and my low back. Last year I had a lumbar fusion with the new bone growth rhBMP. It worked beautifully. Now I need a neck fusion. Can they do the same operation to fuse my neck?
Answer:Spine fusion is commonly done with good results. Bone growth factors such as rhBMP-2 used as a bone graft substitute work well with the lumbar spine and have been approved by the FDA.
However, the use of rhBMP-2 is not approved yet for use with the cervical spine. The manufacturer has even issued a safety alert about this product. Swelling at the front of the neck can occur causing breathing and swallowing problems.
A formal study was done by surgeons at two universities separate from the manufacturing company of this product. Patients ranging in ages from 12 to 81 years old were included. All had an anterior cervical fusion. Some received the rhBMP-2 bone substitute. Others did not.
The rhBMP-2 group had 10 times the cases of anterior neck swelling compared to the group who did not have this treatment. Complications were severe enough to keep people in the hospital longer. Some patients had to come back to the hospital for further treatment after going home.
More studies are needed before this product can be used safely in cervical spine fusions. Ask your surgeon for his or her input. It may not be an option in your area. Other methods of cervical spine fusion may be more reliable with a better safety record.Joseph D. Smucker, MD, et al. Increased Swelling Complications Associated with Off-Label Usage of rhBMP-2 in the Anterior Cervical Spine. In Spine. November 15, 2006. Vol. 31. No. 24. Pp. 2813-2819.
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