Bone Morphogenetic Protein for Pseudarthrosis Repair in Revision Cervical Spine Surgery

Recombinant human bone morphogenetic proteins (rhBMPs) are potent osteoinductive factors that are being considered as bone graft alternatives. Well-performed prospective clinical studies have demonstrated the efficacy of such products for defined indications. This technology may be appropriate for challenging fusion scenarios, such as revision cervical spine surgery. There are recent reports of rhBMPs being used for primary anterior cervical spine surgery and rhBMPs have been demonstrated to overcome posterolateral lumbar pseudarthroses in animal models. Recently, complications have been reported with the off-label use of rhBMPs in anterior cervical spine surgery. In considering rhBMP for revision cervical surgery, the appropriate dose, carrier, and surgical techniques should be further defined and optimized.