From the Departments of Radiology and Imaging (F.A., E.T.T., D.B.S., J.L.C.).
Spine Surgery (F.A., D.R.L.), Hospital for Special Surgery, New York, New York.
AJNR Am J Neuroradiol. 2023 Mar;44(3):351-355. doi: 10.3174/ajnr.A7799. Epub 2023 Feb 16.
Bone morphogenetic protein is broadly used in spinal surgery to enhance fusion rates. Several complications have been associated with the use of bone morphogenetic protein, including postoperative radiculitis and pronounced bone resorption/osteolysis. Bone morphogenetic protein-related epidural cyst formation may represent another complication that has not been described aside from limited case reports. In this case series, we retrospectively reviewed imaging and clinical findings of 16 patients with epidural cysts on postoperative MR imaging following lumbar fusion. In 8 patients, mass effect on the thecal sac or lumbar nerve roots was noted. Of these, 6 patients developed new postoperative lumbosacral radiculopathy. During the study period, most patients were managed conservatively, and 1 patient required revision surgery with cyst resection. Concurrent imaging findings included reactive endplate edema and vertebral bone resorption/osteolysis. Epidural cysts had characteristic findings on MR imaging in this case series and may represent an important postoperative complication in patients following bone morphogenetic protein-augmented lumbar fusion.
骨形态发生蛋白被广泛应用于脊柱外科以提高融合率。使用骨形态发生蛋白与一些并发症相关，包括术后神经根炎和明显的骨质吸收/骨溶解。骨形态发生蛋白相关的硬膜外囊肿形成可能是另一种并发症，除了有限的病例报告外，尚未有描述。在本病例系列中，我们回顾性分析了 16 例腰椎融合术后磁共振成像（MRI）显示硬膜外囊肿的患者的影像学和临床表现。在 8 例患者中，硬脊膜囊或腰神经根受压。其中，6 例患者出现新的术后腰骶神经根病。在研究期间，大多数患者接受保守治疗，1 例患者需要进行囊肿切除的翻修手术。同时存在的影像学表现包括反应性终板水肿和椎体骨质吸收/骨溶解。本病例系列中硬膜外囊肿在 MRI 上具有特征性表现，可能是骨形态发生蛋白增强型腰椎融合术后患者的一个重要术后并发症。
