Journal article
Complications associated with recombinant human bone morphogenetic protein use in pediatric craniocervical arthrodesis: Clinical article
Journal of neurosurgery. Pediatrics, Vol.7(5), pp.468-474
2011
DOI: 10.3171/2011.2.PEDS10487
PMID: 21529186
Abstract
Object: Management of pediatric occipitocervical instability remains especially challenging. The off-label use of recombinant human bone morphogenetic protein (rhBMP)-2 for spinal fusion has increased with a well-documented increase in fusion rate in many case series. Unfortunately, recent reports have documented complications associated with rhBMP use in adult spinal fusions. Complications associated with the use of rhBMP in pediatric spinal surgery is less well understood. In this study the authors report on the fusion rate and complications associated with rhBMP in pediatric occipitocervical arthrodesis.
Methods: The authors reviewed the medical records of those patients 18 years old and younger who underwent dorsal occipitocervical fusion from January 2004 to December 2007 at the University of Iowa Hospitals and Clinics. Forty-eight patients were identified who received rhBMP-augmented fusion. The clinical outcome and complications of these fusions were analyzed.
Results: All 48 patients had fusion confirmed on lateral radiographs within 4-14 months with an average fusion time of 6.7 months. There were 6 complications, 5 of which included seroma formation. Two of 5 patients who developed postoperative seroma presented with symptoms suggesting brainstem compression and obstructive hydrocephalus requiring emergency reoperation. One patient developed heterotopic bone formation causing cervicomedullary compression requiring reoperation.
Conclusions: The use of rhBMP to augment autograft in occipitocervical fusion allows for a high rate of successful arthrodesis, but is associated with potentially life-threatening complications in pediatric patients.
Details
- Title: Subtitle
- Complications associated with recombinant human bone morphogenetic protein use in pediatric craniocervical arthrodesis: Clinical article
- Creators
- Timothy E LINDLEY - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesNader S DAHDALEH - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesArnold H MENEZES - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesKingsley O ABODE-IYAMAH - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery. Pediatrics, Vol.7(5), pp.468-474
- Publisher
- American Association of Neurological Surgeons; Charlottesville, VA
- DOI
- 10.3171/2011.2.PEDS10487
- PMID
- 21529186
- ISSN
- 1933-0707
- eISSN
- 1933-0715
- Language
- English
- Date published
- 2011
- Academic Unit
- Stead Family Department of Pediatrics; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040388502771
Metrics
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