ABSTRACT

Objectives:

To report a case of late neurolo-gic compromise by heterotopic bone formation after use of human bone morphogenetic protein (rhBMP-2) in posterior lumbar interbody fusion (PLIF) procedure.

Summary of background data:

Bone morp-hogenic proteins have been the subject of nu-merous research studies for the last decades. Although available evidence suggests that the use of bone morphogenic proteins to promote human spine fusion is effective and safe there are some concerns about the possibility of new bone formation proximal to neural structure. While new bone formation has been observed in PLIF cases, no neurological compromise have been reported to date.

Methods:

38 year-old female patient with nerve root compression symptoms due to hete-rotopic bone formation induced by rhBMP-2 after the PLIF procedure is reported.

Results:

Patients neurologic symptoms subsi-ded after the removal of heterotopic bony tissue.

Conclusion:

Bone morphogenic proteins are potent osteoinductive agents. Use of BMP could lead to heterotopic ossification with possible int-racanal bone formation. The PLIF technique in-herently requires a laminectomy and placement of the interbody device with close proximity of the neural tissues. Using bone morphogenic proteins with this technique should be approac-hed with caution because of the possible intra-canal new bone formation and unexpected ne-urologic compromise.