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BMP update for 2011 please

Gwal5GGwal5 Posts: 6
edited 06/11/2012 - 8:55 AM in Back Surgery and Neck Surgery
I am having an alif plif fusion done at L5S1 with titanium cage. I have read much on this site about BMP especially the posts in 2009. In 2009 ERNurse stated that the trend was shifting to Autograft. So what's the currently favored choice by surgeons? Can't find many 2011 posts regarding BMP. Those that have had recent fusions, can you let me know if you had BMP and if any side effects occurred? If not BMP then please comment on autograft or allograft results. From all the reading I think I prefer my own bone (from my spine if there is enough) with maybe bone marrow from my hip. Thank you.


  • I had my ACDF done in February this year and I was fused within 3 months. My NS is one of the best in the country affiliated with a university hospital in NYC. Autografts are used for patients with a high risk of non-fusion, but also increases pain post-op. I think it depends on your current health and the preference of your surgeon.
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • Lumbar fusions have a lot more bone to fuse as the bone in that area is larger, verses the cervical spine. There are some more releases that have come out on BMP, and actually the last one I got was from ERnurse, as I still chat with her. If you google "US bone growth studies under fire for alleged bias", you will come up with the links. It was published in a medical journal this past July. Myself I am from the cervical side and had psuedoarthrosis(sp), so I have had both BMP and used my bone. The major issue I had was swelling, and over growth, but there are some other contradictions that can happen in the lumbar region. Sense your surgeon is using the posterior approach, I would assume he would get bone graft from the posterior hip side as well. I have had it both anterior and posterior, and the posterior incision is not to painful. I would bet they wouldn't turn you during surgery to get anterior bone. But if you choose allograft ask your surgeon which side he/she will be taking from, as pain wise and comfort it will make a difference. I forgot to mention BMP is authorized for the exact surgery your surgeon is suggesting, a one level posterior entry.

    If you remember right Ernurse had a bad outcome as the surgeon placed the BMP on the nerve roots and bone grew on the nerve roots, which caused her extreme pain, about the 6 week mark, which is about the time frame it takes. That is about the same time my pain started returning. Mine has been cleaned us has Ernurse, but not before permanent damage had occurred to the nerves.

    When they place that stuff in you it is absorbed by the body, by the time you have left the hospital, although it has done its work as well, and called in the growing agents, so that is how that happens. I think most surgeons are well aware of this now, so they know the risk of using it more. But there are pro's with it as well, I can say in the cervical spine, I was almost fused completely at 5 weeks. So if used properly it can be a huge bonus, with recover times.

    My opinion is how much do you trust your surgeon? How many times has he/she used it and for how long have they been using it? Hope this helps a little bit, good luck and keep us posted what you decide to do.
  • My surgery is a 360 so its an anterior and posterior fusion. My surgeon is top notch at a major hospital and uses BMP frequently. I do fully trust him but don't want to wind up as one of the unlucky ones with an inflammation response/allergic reaction, bmp induced radiculopathy or bone overgrowth. If surgeons are more cautious with BMP these days maybe it's now a safer product? He wants to use BMP and bone from my spine in a titanium cage.
  • Unfortunately there is no evidence to suggest that. I think what should be considered and I didn't see the answers in this new informations is why it is happening? If I am not mistaken the north American spine society just recently released after those latest ones, that the gold standard will be Autograft, for patients with fusion issues. My personal take is I would prefer to always use my bone, but there is something you should know and consider on autograft as well. Once they use say the left illac crest it can't be used again, as the bone does not grow again. It puts some surgeons in a place of considering all the medical evidence they have on you and family history and the possibility of if you will develop osteo. Once they have used the four sides of the illiac crest they can only get bone from the long bone in the leg or some place else. While no one would ever consider you might need that much bone it is something to consider, when making choices. You can see I am neither pro on any of the choices, just think you should be as informed as possible to make the best choice for your individual situation. You might want to sit with your surgeon and do the pro's con's and what he see's. The good news with either method you should fuse.
  • Hello everyone

    I had revision of L4/5-S1 decompression in July and the surgeon used BMP. I was great for the first couple of moonths but have now developed severe radicular pain in the areas of my right leg consistent with S1 and L5 nerve damage.

    I had an MRI and blood work, no infections or swelling showed up or bony overgrowth - plus my right side has got the titanium screws and rod in place and all of it hasn't moved post-op.

    The surgeon thinks it could be a reaction to the BMP.

    I have read that there is an increased chance of radiating leg pain occuring if BMP is used, so I hope it's that and it will settle down. My surgeon seems to think it will settle down, but i have no idea of time frame.

    Does anyone have any similar experiences post BMP use?



  • They used BMP with my fusion as well. I haven't had any issues due to the use of BMP, but I have had other issues in general. If you go back and look at ERNURSE posts, she documented issues with BMP very well. It's such a shame she has to live with the results of flawed medical research and development.

    If I'm not mistaken, it also depends on what type BMP they use along with the location. It was my understanding that BMP is contraindicated with any ACDF procedures.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Cheers Keith.

    I have read ERNurse's posts from back in 2009 - and a whole lot more on BMP [or InFuse] in the recent article in the Spine Journal [Eugene Carragee], the response from the manufacturers and the ensuing involvement of the US Senate.

    Yale have been given $2.5m by the manufacturer to do an independent review of BMP.

    In the UK it remains 'not in remit' under our version of the FDA, NICE, but obviously can be used in private operations, such as mine. My surgeon has a 100% success rate in terms of obtaining fusion using BMP and it now looks to me that is how he gauges whether the op has worked or not. Side effects will 'clear up in time' he says...

    Put it this way, a lot of the detail of side-effects has only really come to light in July/August via the Carragee article and for me it's a case of 'if I'd known then what I know now ...'

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