Abstract | BACKGROUND CONTEXT: Human recombinant bone morphogenetic protein-2 (BMP-2) is commonly used in spinal surgery to augment arthrodesis, and a number of potential complications have been documented. PURPOSE: To present the case of a delayed radiculopathy that occurred because of a calcified perineural cyst that formed after an L4-L5 transforaminal lumbar interbody fusion (TLIF) in which BMP-2 was used. STUDY DESIGN/SETTING: Case report of a 70-year-old man presented with back and right lower extremity pain. METHODS: A 70-year-old man who had previously undergone a right L4-L5 TLIF presented 20 months after surgery with progressively radiating right leg pain. Imaging revealed a right-sided L4-L5 cystic lesion posterior to the interbody cage. The patient underwent reexploration, and a calcified mass was discovered. RESULTS: Histopathology revealed fragments of organized collagenous connective tissue, new collagen, and partially calcified fragments of fibrocartilage, bone, and ligament. CONCLUSIONS: This is the first reported case of a symptomatic calcified perineural cyst developing after a fusion procedure in which BMP-2 was used. The presence of connective tissue with metaplastic bone formation and maturation within the lesion suggests that formation of the cyst was secondary to application of BMP-2, as it possesses both osteogenic and chondrogenic capabilities.
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Authors | Khoi D Than, Shayan U Rahman, Paul E McKeever, Anthony C Wang, Frank La Marca, Paul Park |
Journal | The spine journal : official journal of the North American Spine Society
(Spine J)
Vol. 13
Issue 8
Pg. e31-5
(Aug 2013)
ISSN: 1878-1632 [Electronic] United States |
PMID | 23792101
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Bone Morphogenetic Proteins
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Topics |
- Aged
- Bone Morphogenetic Proteins
(adverse effects, therapeutic use)
- Humans
- Lumbar Vertebrae
(pathology, surgery)
- Male
- Radiculopathy
(etiology, pathology, surgery)
- Spinal Fusion
(adverse effects, instrumentation)
- Tarlov Cysts
(etiology, pathology, surgery)
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