{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:04:19Z","timestamp":1783602259795,"version":"3.55.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Management of pediatric occipitocervical instability remains especially challenging. The off-label use of recombinant human bone morphogenetic protein (rhBMP)-2 for spinal fusion has increased with a well-documented increase in fusion rate in many case series. Unfortunately, recent reports have documented complications associated with rhBMP use in adult spinal fusions. Complications associated with the use of rhBMP in pediatric spinal surgery is less well understood. In this study the authors report on the fusion rate and complications associated with rhBMP in pediatric occipitocervical arthrodesis.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors reviewed the medical records of those patients 18 years old and younger who underwent dorsal occipitocervical fusion from January 2004 to December 2007 at the University of Iowa Hospitals and Clinics. Forty-eight patients were identified who received rhBMP-augmented fusion. The clinical outcome and complications of these fusions were analyzed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>All 48 patients had fusion confirmed on lateral radiographs within 4\u201314 months with an average fusion time of 6.7 months. There were 6 complications, 5 of which included seroma formation. Two of 5 patients who developed postoperative seroma presented with symptoms suggesting brainstem compression and obstructive hydrocephalus requiring emergency reoperation. One patient developed heterotopic bone formation causing cervicomedullary compression requiring reoperation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The use of rhBMP to augment autograft in occipitocervical fusion allows for a high rate of successful arthrodesis, but is associated with potentially life-threatening complications in pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.2.peds10487","type":"journal-article","created":{"date-parts":[[2016,12,27]],"date-time":"2016-12-27T13:07:55Z","timestamp":1482844075000},"page":"468-474","source":"Crossref","is-referenced-by-count":39,"title":["Complications associated with recombinant human bone morphogenetic protein use in pediatric craniocervical arthrodesis"],"prefix":"10.3171","volume":"7","author":[{"given":"Timothy E.","family":"Lindley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader S.","family":"Dahdaleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold H.","family":"Menezes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kingsley O.","family":"Abode-Iyamah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0070468","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s00381-008-0607-7","article-title":"Fusions at the craniovertebral junction","volume":"24","author":"Ahmed","year":"2008"},{"key":"b2-0070468","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1097\/01.BRS.0000065486.22141.CA","article-title":"A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate","volume":"28","author":"Baskin","year":"2003"},{"issue":"5 Suppl 2","key":"b3-0070468","series-title":"Neurosurgery","first-page":"ONS423","article-title":"A comprehensive review of the safety profile of bone morphogenetic protein in spine surgery","volume":"62","author":"Benglis","year":"2008"},{"key":"b4-0070468","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"521","DOI":"10.3171\/spi.2005.2.5.0521","article-title":"Anterior cervical discectomy and fusion involving a polyetheretherketone spacer and bone morphogenetic protein","volume":"2","author":"Boakye","year":"2005"},{"key":"b5-0070468","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1001\/jama.2009.956","article-title":"Prevalence, complications, and hospital charges associated with use of bonemorphogenetic proteins in spinal fusion procedures","volume":"302","author":"Cahill","year":"2009"},{"key":"b6-0070468","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1227\/NEU.0b013e3181f258ba","article-title":"Routine use of recombinant human bone morphogenetic protein-2 in posterior fusions of the pediatric spine: safety profile and efficacy in the early postoperative period","volume":"67","author":"Fahim","year":"2010"},{"key":"b7-0070468","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1227\/01.NEU.0000369517.21018.F2","article-title":"Formation of painful seroma and edema after the use of recombinant human bone morphogenetic protein-2 in posterolateral lumbar spine fusions","volume":"66","author":"Garrett","year":"2010"},{"issue":"6 Suppl","key":"b8-0070468","series-title":"J Neurosurg","first-page":"480","article-title":"Bone morphogenetic protein for salvage fusion in an infant with Down syndrome and craniovertebral instability. 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