{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T04:59:43Z","timestamp":1773809983964,"version":"3.50.1"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec><jats:title>Object<\/jats:title><jats:p>Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been approved for use in the lumbar spine in conjunction with the lumbar tapered cage. However, off-label use of this osteoinductive agent is observed with anterior fusion applications as well as with both posterior lumbar interbody fusion and transforaminal lumbar interbody fusion (TLIF). Complications using rhBMP-2 in the cervical spine have been reported. Although radiographic evidence of ectopic bone in the lumbar spine has been described following rhBMP-2 use, this finding was not previously believed to be of clinical relevance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a retrospective review of 4 patients who underwent minimally invasive spinal TLIF (MIS-TLIF) in which bone fusion was augmented with rhBMP-2 applied to an absorbable collagen sponge. Case presentations, operative findings, imaging data, and follow-up findings were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four cases with delayed symptomatic neural compression following the off-label use of rhBMP-2 with MIS-TLIF were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although previously believed to be only a radiographic finding, the development of ectopic bone following rhBMP-2 use in lumbar fusion can be clinically significant. This paper describes 4 cases of delayed neural compression following MIS-TLIF. The reader should be aware of this potential complication following the off-label use of rhBMP-2 in the lumbar spine.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.4.spine0876","type":"journal-article","created":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T21:56:30Z","timestamp":1262296590000},"page":"40-46","source":"Crossref","is-referenced-by-count":117,"title":["Symptomatic ectopic bone formation after off-label use of recombinant human bone morphogenetic protein-2 in transforaminal lumbar interbody fusion"],"prefix":"10.3171","volume":"12","author":[{"given":"Nan-Fu","family":"Chen","sequence":"first","affiliation":[{"name":"1Division of Neurosurgery, Department of Surgery, Armed Forces Kaohsiung General Hospital, Kaohsiung, Taiwan;"},{"name":"2Division of Neurosurgery, UCLA Medical Center, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary A.","family":"Smith","sequence":"additional","affiliation":[{"name":"2Division of Neurosurgery, UCLA Medical Center, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Stiner","sequence":"additional","affiliation":[{"name":"2Division of Neurosurgery, UCLA Medical Center, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Armin","sequence":"additional","affiliation":[{"name":"2Division of Neurosurgery, UCLA Medical Center, Los Angeles; and"},{"name":"3Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hormoz","family":"Sheikh","sequence":"additional","affiliation":[{"name":"2Division of Neurosurgery, UCLA Medical Center, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry T.","family":"Khoo","sequence":"additional","affiliation":[{"name":"2Division of Neurosurgery, UCLA Medical Center, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199804000-00001"},{"key":"b2-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200002010-00020"},{"key":"b3-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199407000-00002"},{"key":"b4-0120040","doi-asserted-by":"crossref","first-page":"E654","DOI":"10.1097\/BRS.0b013e31817c4f1c","volume":"33","author":"Brower RS","year":"2008","journal-title":"Spine (Phila Pa 1976)"},{"key":"b5-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00024720-200210000-00001"},{"key":"b6-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200211010-00015"},{"key":"b7-0120040","doi-asserted-by":"crossref","first-page":"2748","DOI":"10.1097\/00007632-199712010-00009","volume":"22","author":"Butterman GR","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"key":"b8-0120040","doi-asserted-by":"crossref","first-page":"729","DOI":"10.5435\/00124635-200812000-00005","volume":"16","author":"Daniels AH","year":"2008","journal-title":"J Am Acad Orthop Surg"},{"key":"b9-0120040","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.03.004"},{"key":"b10-0120040","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2004.03.025"},{"key":"b11-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198912000-00009"},{"key":"b12-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200208151-00014"},{"key":"b13-0120040","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100533"},{"key":"b14-0120040","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1302\/0301-620X.74B2.1544970","volume":"74","author":"Miyamoto S","year":"1992","journal-title":"J Bone Joint Surg Br"},{"key":"b15-0120040","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2004.1.1.0019"},{"key":"b16-0120040","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00003086-199302000-00017","volume":"287","author":"Nugent PJ","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"b17-0120040","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.spinee.2005.11.006","volume":"6","author":"Patel VV","year":"2006","journal-title":"Spine J"},{"key":"b18-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200208151-00008"},{"key":"b19-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000112045.36255.83"},{"key":"b20-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000132291.50455.d0"},{"key":"b21-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000201424.27509.72"},{"key":"b22-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00024720-200608000-00008"},{"key":"b23-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000245863.52371.c2"},{"key":"b24-0120040","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1302\/0301-620X.71B4.2768321","volume":"71","author":"Summers BN","year":"1989","journal-title":"J Bone Joint Surg Br"},{"key":"b25-0120040","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0351-9"},{"key":"b26-0120040","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.3.6.0436"},{"key":"b27-0120040","first-page":"263","volume":"66","author":"Wetzel FT","year":"1993","journal-title":"Yale J Biol Med"},{"key":"b28-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199903000-00015"},{"key":"b29-0120040","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.06.014"},{"key":"b30-0120040","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-198909000-00002"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/12\/1\/article-p40.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/12\/1\/article-p40.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T09:55:45Z","timestamp":1685354145000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/12\/1\/article-p40.xml"}},"subtitle":["Report of 4 cases"],"short-title":[],"issued":{"date-parts":[[2010,1]]},"references-count":30,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2009.4.spine0876","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2010,1]]}}}