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Fatal Fat Embolism Syndrome After Posterior Spinal Fusion: A Case Report.
Cureus
October 2024
Orthopedic Surgery, MedStar Washington Hospital Center, Washington, DC, USA.
Posterior spinal fusion with instrumentation is a routine elective treatment of lumbar stenosis with radiculopathy and myelopathy. Fat embolism syndrome (FES) is a rare complication of this procedure. We describe the first documented case of fatal FES after an L3-L5 posterior spinal fusion using off-label bone morphogenic protein 2 (BMP-2) and allograft instead of iliac crest bone grafting.
View Article and Find Full Text PDFOpen Reduction and Internal Fixation with Bone Morphogenetic Protein-2 for Correction of Nonunion Humeral Shaft Fracture with Pseudoarthrosis in the Geriatric Population: A Case Report.
J Orthop Case Rep
November 2024
Alpine Orthopaedic and Spine, 212 E Central Ave # 365, Spokane, WA 99208, USA.
Introduction: Bone morphogenic protein-2 (BMP-2) is a potent growth factor cytokine, with indications for interbody spinal fusion surgery and open tibial shaft repairs due to its osteoinductive properties. Off-label usage of BMP-2 has been documented; however, there are limited studies regarding the efficacy of using BMP-2 in non-union humeral shaft fractures.
Case Report: We present a case of a comminuted left humeral shaft fracture with pseudoarthrosis in a 64-year-old woman.
Off-Label Bone Morphogenetic Protein 2 Use Results in Successful Posterolateral Lumbar Fusion in a Veteran Population.
J Am Acad Orthop Surg Glob Res Rev
October 2024
From the Department of Orthopaedic Surgery, Division of Spine Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr. Munsch, Dr. Dalton, Dr. Chen, Dr. Tang, Dr. Como, Dr. Whaley, Dr. Sadhwani, Dr. Fourman, Dr. Shaw, and Dr. Lee); Department of Surgery, Orthopaedic Surgery Service, VA Pittsburgh Medical Center, Pittsburgh, PA (Dr. Munsch, Dr. Dalton, Dr. Chen, Dr. Fourman, Dr. Shaw, and Dr. Lee); the Pittsburgh Orthopaedic Spine Research Group (POSR), Pittsburgh, PA (Dr. Munsch, Dr. Dalton, Dr. Chen, Dr. Tang, Dr. Como, Dr. Whaley, Dr. Shaw, and Dr. Lee); and the Orland Bethel Family Musculoskeletal Research Center (BMRC), Pittsburgh, PA (Dr. Chen, Dr. Tang, Dr. Como, Dr. Shaw, and Dr. Lee).
Introduction: Patients within the US Veterans Health Administration (VA) system have higher rates of comorbidities and chronic pain, increasing risks of complications/poor outcomes following spine surgery. Although the use of bone morphogenetic protein 2 (BMP-2) is established for anterior lumbar interbody fusion, its indications for off-label use in posterolateral fusion are unclear. The objective of this study was to evaluate safety and utility of BMP-2 in posterolateral fusion through a 15-year experience at the VA.
View Article and Find Full Text PDFThe neurofibromatosis type 1 (NF1) RASopathy is associated with persistent fibrotic nonunions (pseudarthrosis) in human and mouse skeletal tissue. Here, we performed spatial transcriptomics to define the molecular signatures occurring during normal endochondral healing following fracture in mice. Within the control fracture callus, we observed spatially restricted activation of morphogenetic pathways, such as TGF-β, WNT, and BMP.
View Article and Find Full Text PDFBone morphogenetic protein in subaxial cervical arthrodesis: a meta-analysis of 5828 patients.
J Neurosurg Spine
August 2024
1Department of Neurologic Surgery, Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester; and.
Article Synopsis
- The study investigates the effects of bone morphogenetic protein (BMP) on clinical and radiological outcomes in cervical arthrodesis, specifically comparing cases with and without BMP use in both anterior and posterior fusions.
- A total of 20 studies with nearly 5,800 patients showed that BMP use in anterior cervical discectomy and fusion (ACDF) was linked to higher fusion rates and lower reoperation rates, but also a higher risk of dysphagia (difficulty swallowing).
- In contrast, for posterior cervical fusion (PCF), BMP did not significantly affect fusion or reoperation rates, but was associated with higher blood loss during surgery.
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