Use of recombinant human bone morphogenetic protein-2 to enhance posterior cervical spine fusion at 2 years of age: technical note.

BACKGROUND

Recombinant human bone morphogenetic protein-2 (rhBMP-2) is a genetically engineered protein which recruits bone-forming cells to the surgical area and converts local cells to bone. In clinical studies, rhBMP-2 successfully enhanced anterior/posterior spinal fusions in adult humans without bone grafts. Efficacy in paediatric spinal fusion is not yet reported.

METHODS

We describe the surgical technique and results in a 2-year-old girl with unstable C1-2 cervical spine injury who underwent non-metal-instrumented C1/C2 posterior spinal fusion using rhBMP-2 applied to an absorbable collagen sponge (ACS) matrix.

RESULTS

Radiologically verifiable bony fusion began at 3 weeks. Within 8 weeks solid C1-C2 spinal fusion was confirmed by CT scan. There was no evidence of spinal canal encroachment and no adverse effects related to the rhBMP-2/ACS-carrier matrix.

CONCLUSION

rhBMP-2 enhanced posterior cervical fusion at an impressive rate in a very young child. This finding is encouraging both to effectiveness and speed. However, with all new developments, we highlight the need for further experience and longer follow-up in children.