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Spinal arthrodesis (fusion)

It is a surgical option for chronic back pain.

Spinal fusion, also known as spondylodesis or spondylosyndesis.

Surgical technique used to join two or more vertebrae.

Bone tissue, either from the patient or a donor, is used in conjunction with the body’s natural bone growth processes to fuse the vertebrae.

Technique is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the faulty vertebrae themselves.

Technique to treat most spinal deformities, specifically scoliosis and kyphosis.

Bone-morphogenetic proteins (BMP) promote bone creation and remodeling and use of recombinant BMP is available for surgery of the anterior lumbar spine.

BMP use increases the likelihood of bony fusion and decreases the undesired outcomes of pseudo-arthrosis or nonunion.

The use of BMP decreases morbidity from bone graft harvest because solid fusion may be achieved without the need for an autologous graft.

Postoperative neck edema has been reported following the use of BMP in the anterior cervical spine and occurs in 7 to 50% of cases (Smucker, Tumialan,Shields).

The neck edema that occurs with cervical intra-body fusion may result in airway and neurologic compression.

BMP is used in approximately 24% of all fusions.

Patients more likely to receive bone morphogenetic proteins include women and white elderly.

In a study of 17,000 fusions in 2006 utilizing BMP, an estimated 50%, higher complication was noted in anterior cervical fusion within overall complication rate of 7.09% (Cahill).

Use of BMP in anterior cervical fusion was associated with greater likelihood of wound related complications dysphagia or voice related complications.

Use of BMP and lumbar veracity of posterior cervical fusions does not appear to be associated with greater frequency of complications.

BMP use in anterior cervical fusion increases hospital length of stay and costs.

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