RT Journal Article
SR Electronic
T1 Predictive Factors and Rates of Fusion in Minimally Invasive Transforaminal Lumbar Interbody Fusion Utilizing rhBMP-2 or Mesenchymal Stem Cells
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 46
OP 52
DO 10.14444/6007
VO 13
IS 1
A1 OVERLEY, SAMUEL C.
A1 MCANANY, STEVEN J.
A1 ANWAR, MUHAMMAD A.
A1 MERRILL, ROBERT K.
A1 LOVY, ANDREW
A1 GUZMAN, JAVIER Z.
A1 ZHADANOV, SERGEY
A1 DOSHI, AMISH
A1 ROTHENBERG, EDWARD
A1 VAISHNAV, AVANI
A1 GANG, CATHERINE
A1 QURESHI, SHEERAZ A.
YR 2019
UL https://www.ijssurgery.com/content/13/1/46.abstract
AB Background: Several fusion adjuncts exist to enhance fusion rates during minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). The objective of this study was to compare fusion rates in patients undergoing MI-TLIF with either rhBMP-2 or cellularized bone matrix (CBM).Methods: We conducted a single surgeon retrospective cohort study of patients who underwent MI-TLIF with either rhBMP-2 or CBM placed in an interbody cage. Single and multilevel procedures were included. Fusion was assessed on computed tomography scans at 12-month follow-up by an independent, blinded, board-certified neuroradiologist. Fusion rates and rate of revision surgery were compared with a Fisher exact test between the 2 groups. A multivariate regression analysis was performed to identify patient factors that were predictive of radiographic nonunion after MI-TLIF.Results: A total of 93 fusion levels in 78 patients were reviewed. Thirty-nine patients received CBM, and 39 patients received rhBMP-2. The patients receiving rhBMP-2 were older on average (61.4 vs 55.6, P = .03). The overall fusion rate was 68% in the CBM group (32/47 levels) and 78% in the rhBMP-2 group (36/46) (P = .35). Only preoperative hypertension was predictive of radiographic nonunion (odds ratio = 3.5, P = .05). There were 3 smokers in the CBM group and 4 smokers in the BMP group, and 1 in each group experienced radiographic pseudarthrosis. A total of 4 patients, 3 in the CBM group and 1 in the BMP group (P = .61), required revision for symptomatic pseudarthrosis. All of these patients had a single-level index procedure.Conclusions: There were no differences in radiographic fusion and rate of revision surgery in patients who underwent MI-TLIF with either rhBMP-2 or CBM as fusion adjuncts.Level of Evidence: 3Clinical Relevance: Both rhBMP-2 and CBMs can be used as effective fusion adjuncts without any clear advantage of one over the other.