RESUMEN
OBJECTIVE: To report the operative outcomes after treating vertebral osteomyelitis patients with an anterior cervical corpectomy and fusion procedure using recombinant human bone morphogenetic protein-2 (rhBMP-2) as graft material. METHODS: A retrospective review of electronic medical records of 26 adult patients who underwent an anterior cervical corpectomy and fusion procedure for cervical osteomyelitis using rhBMP-2 at the University of Puerto Rico University District Hospital was performed. Indication, preoperative laboratory results, levels of corpectomy, preoperative American Spinal Injury Association Impairment Scale (ASIA) score, complications, fusion evaluation at 12 months, and ASIA score at 12 months were reviewed. RESULTS: For the cohort of patients, mean age was 47 ± 13 years and 65% were male. Spinal instability was present in 54%. The levels of corpectomy were: 1 level in 2 cases, 2 levels in 15 cases, 3 levels in 8 cases, and 5 levels in 1 case. Four patients had complications and, of these, 2 experienced dysphagia. The fusion rate was 100% and no reoperations were performed. An improvement in ASIA score was seen for 54% patients at 12-month follow-up. CONCLUSIONS: This study demonstrates a fusion rate of 100% with no reoperations reported. Recombinant human bone morphogenetic protein-2 could be considered and further researched as grafting material for anterior cervical corpectomy and fusion procedures in cervical osteomyelitis patients.
Asunto(s)
Proteína Morfogenética Ósea 2 , Vértebras Cervicales , Osteomielitis , Proteínas Recombinantes , Fusión Vertebral , Humanos , Masculino , Proteína Morfogenética Ósea 2/uso terapéutico , Fusión Vertebral/métodos , Persona de Mediana Edad , Osteomielitis/cirugía , Osteomielitis/tratamiento farmacológico , Femenino , Vértebras Cervicales/cirugía , Proteínas Recombinantes/uso terapéutico , Adulto , Estudios Retrospectivos , Resultado del Tratamiento , Factor de Crecimiento Transformador beta/uso terapéutico , AncianoRESUMEN
Laser ablation is an emerging, minimally invasive treatment for selected children with intractable focal epilepsy with improved procedural morbidity. Data for children lag similar studies in adults, but the hope is for near-equivalent seizure-control rates and improved neuropsychological outcome when compared with standard open surgical resection. The approach seems particularly beneficial when dealing with deep, focal lesions, such as hypothalamic hamartomas or hippocampal sclerosis.