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Postoperative Lumbar Fusion Bone Morphogenic Protein-Related Epidural Cyst Formation
F Abel1,2, E T Tan1, D B Sneag1
1From the Departments of Radiology and Imaging (F.A., E.T.T., D.B.S., J.L.C.).
AJNR. American Journal of Neuroradiology
|February 16, 2023
Summary
Bone morphogenetic protein (BMP) use in spinal fusion may cause epidural cysts. These cysts can lead to nerve compression and radiculopathy, requiring further investigation and potential intervention.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Radiology
Background:
- Bone morphogenetic protein (BMP) is widely used in spinal surgery to improve fusion rates.
- Complications associated with BMP include radiculitis and osteolysis.
- BMP-related epidural cyst formation is an underreported complication.
Purpose of the Study:
- To describe the imaging and clinical findings of BMP-related epidural cysts after lumbar fusion.
- To identify characteristic MR imaging features of these cysts.
- To assess the clinical significance and management of these complications.
Main Methods:
- Retrospective review of 16 patients with epidural cysts post-BMP-augmented lumbar fusion.
- Analysis of postoperative MR imaging and clinical data.
- Correlation of imaging findings with neurological symptoms.
Main Results:
- Epidural cysts were identified on postoperative MR imaging in 16 patients.
- Mass effect on neural structures was observed in 8 patients.
- 6 patients developed new postoperative lumbosacral radiculopathy.
- Concurrent findings included endplate edema and vertebral bone resorption.
Conclusions:
- BMP-related epidural cysts are a potential complication following lumbar fusion.
- Characteristic MR imaging findings can aid in diagnosis.
- These cysts may cause significant neurological deficits, necessitating awareness and management strategies.
