Use of Recombinant Human Bone Morphogenetic Protein-2 after Anterior Cervical Corpectomy and Fusion for the Treatment of Vertebral Osteomyelitis

Adriana Vazquez Medina; Gisela Murray Ortiz; Samuel Estronza Ojeda; Aixa de Jesus Espinosa; Emil A Pastrana

doi:10.1016/j.wneu.2024.03.047

Use of Recombinant Human Bone Morphogenetic Protein-2 after Anterior Cervical Corpectomy and Fusion for the Treatment of Vertebral Osteomyelitis

World Neurosurg. 2024 Mar 18:S1878-8750(24)00431-5. doi: 10.1016/j.wneu.2024.03.047. Online ahead of print.

Authors

Adriana Vazquez Medina¹, Gisela Murray Ortiz¹, Samuel Estronza Ojeda¹, Aixa de Jesus Espinosa¹, Emil A Pastrana²

Affiliations

¹ Medical Student (Vazquez Medina), University of Puerto Rico School of Medicine, Medical Sciences Campus, Department of Neurological Surgery, University of Puerto Rico Medical Sciences Campus (Murray Ortiz, Estronza Ojeda, De Jesus Espinosa and Pastrana).
² Medical Student (Vazquez Medina), University of Puerto Rico School of Medicine, Medical Sciences Campus, Department of Neurological Surgery, University of Puerto Rico Medical Sciences Campus (Murray Ortiz, Estronza Ojeda, De Jesus Espinosa and Pastrana). Electronic address: emil.pastrana@upr.edu.

PMID: 38508383
DOI: 10.1016/j.wneu.2024.03.047

Abstract

Objective: To report the operative outcomes after treating vertebral osteomyelitis patients with an anterior cervical corpectomy and fusion procedure using recombinant human bone morphogenetic protein-2 as graft material.

Materials and methods: A retrospective review of electronic medical records of 26 adult patients who underwent an anterior cervical corpectomy and fusion procedure for cervical osteomyelitis using rhBMP-2 at the University of Puerto Rico University District Hospital was performed. Indication, preoperative laboratory results, levels of corpectomy, preoperative ASIA score, complications, fusion evaluation at 12 months, and ASIA score at 12 months was reviewed.

Results: For the cohort of patients, mean age was 47±13 years and 65% were male. Spinal instability was present in 54%. The levels of corpectomy were: one-level in 2 cases, two-level in 15 cases, three-level in 8 cases and five-level in 1 case. 4 patients had complications and of these, 2 experienced dysphagia. The fusion rate was 100% and no reoperations were performed. An improvement in ASIA score was seen for 54% patients at 12 months follow up.

Conclusions: This study demonstrates a fusion rate of 100% with no reoperations reported. Recombinant human bone morphogenetic protein-2 could be considered and further researched as grafting material for anterior cervical corpectomy and fusion procedures in cervical osteomyelitis patients.

Keywords: Cervical corpectomy and fusion; Cervical osteomyelitis; Recombinant human bone morphogenetic protein-2; Vertebral osteomyelitis.