Re: BMP - complications with ALIF?
ALIF is the only approved usage for BMP, so, assuming you have selected your surgeon with great care, you should be OK.
I don't know how much you know about BMP but there are many class action law suits going on right now due to so many adverse affects from the usage of BMP. So I wouldn't feel comfortable having it unless I knew the surgeon was cautious and very up-to-date with all the literature, etc.
I had BMP with a PEEK cage with my first lumbar fusion, a PLIF at L4-L5. I did not know it was "off-label" usage at the time, nor, actually did I know a thing about BMP at the time....my fusion turned out fine and I had no problems, as far as I know anyway, with the BMP. It did not overgrow the cage or do anything else.
But when I had my last surgery, which was a 3 level fusion, I would not have allowed the surgeon to use it. I wasn't faced with the decision because this surgeon does not use BMP in his practice, so it was a non-issue.
The FDA trials were conducted with anterior lumbar fusion, and the approval was granted for one level anterior fusions using a cage or similar device. One study indicated a fusion rate of 94.5% in the group that had BMP compared to a fusion rate of 88.7% in the control group.