I am planning on having L5-S1 Anterior Lumbar Interbody Fusion (ALIF) surgery this summer and I am wondering what people out there know about the success rate of fusion with BMP. I could use autograft from my iliac crest (hip) bone or use BMP. I know someone who has had nothing but complications with BMP, but his fusion was done posteriorly.
Thanks for any information you might have.
L5-S1 hemilami w/ microdiscectomy 2/18/03 - right leg pain gone
Successful chiropractic care 2005-2011
Daily low back pain and HORRIBLE spasms since 2011
L5-S1 ALIF 6/30/12 - back pain is GONE!
I don't have numbers but I can say mine is fusing well. I had an ALIF at L5/S1 with cages and BMP on 8/8/11. It isn't fully fused yet (that takes a year) but it is in progress. From what I hear, the harvest site can be more troublesome than the fusion site so I think BMP is a great option. I'm very glad I didn't need a harvest site in addition to the belly incision and the fusion itself.
A general remark: Take the surgery seriously....the recovery is VERY long (really, I am STILL healing and it was month 5 before I felt like it was the right choice to do it) and there are risks. You'll find a lot of stories of failed fusions and very real potential complications. But keep it in context...the people with success stories are MUCH less likely to be hanging out in back boards b/c they are out living their lives (I try to be an exception!).
Do be sure you try everything before surgery (PT, epidurals, etc) and be sure your doc is very experienced (mine does multiple ALIFs a week!). But, if you decide to go for it, do keep a positive mindset....it DOES help the majority of people and the majority fuse over time. Also, check out the "pinned" post at the start of the thread for advice on preparing for the recovery period....folks have real advice that you may not get from the doc's folks (surgeons are good at surgery but not always at recovery advice).
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.
Location: San Francisco, California, United States
Re: BMP - complications with ALIF?
My surgeon used an allograft material, rather than autograft or BMP. He has also authored an article finding a correlation between increased cancer rates and BMP. (Google Carregee and BMP for more info.) Apparently there has been some controversy over the results of the study, and I will leave you to your own conclusion regarding study methodologies, etc.
[QUOTE=nordon;4926510]I am planning on having L5-S1 Anterior Lumbar Interbody Fusion (ALIF) surgery this summer and I am wondering what people out there know about the success rate of fusion with BMP. I could use autograft from my iliac crest (hip) bone or use BMP. I know someone who has had nothing but complications with BMP, but his fusion was done posteriorly.
Thanks for any information you might have. [/QUOTE]
Sorry I don't have any info about bmp- had never heard about until recently on here, but my surgery was 10 yrs ago. And I had a 360 lumbar fusion on l4-5 ( and I've never seen anyone mention that word on here either) they went posterior & also anterior( I have screws in the back & one strange looking screw all by itself on front?) anyway the only reason Im putting my 2 cents in is I had bone taken from my hip area( can't remember if it was exactly iliac crest or not but I have had a LIT of pain from the area where they took out bone , have been told it's bursitis but nothing has really ever helped it, I think they just don't want to say they don't know why it hurts other than the fact that they scraped bone out. Just research & weigh your options & good luck!!!
You mentioned one reason why BMP was invented...because so many patients end up with the graft site for bone harvesting hurting longer than the surgery itself. BMP was not approved by the FDA for use in spine surgery until 2002.
The Following User Says Thank You to teteri66 For This Useful Post: Nanacan (02-13-2012)