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Old 10-11-2012, 09:35 PM   #1
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Exclamation Forteo and BMP to fuse c1 c2?

I'm in my 30's and have to have my c1 and c2 fused because of sever neck and head pain. I have instability and they might have to fuse my occiput also, but they won't know until they go in during surgery. The problem is I have low bone density when they gave me a DEXA scan. The doctor suggested I use the Bone Morphogenetic Protein and Forteo for 2 months until the bones fuse. He wants to use donor bone and synthetic bone for the fusion. He wants to be sure they fuse so this is what he recommened. I am just wondering if it's overkill. I read that these things both cause cancer and other side effects. Do they even use both for a fusion? I can't find anything on it from people's experience. I'm also wondering if it could cause too much bone growth. Anyone know about this and can help me figure it out? He said there are other stuff he can use to fuse but he said it's not as good as the BMP. He doesn't want this thing not to fuse because it's worse to have to go back in and try to fuse again.

 
Old 10-11-2012, 10:59 PM   #2
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Re: Forteo and BMP to fuse c1 c2?

You question is sufficiently complex that I hesitate to even make a comment...I think you may need to get a number of opinions from very well-qualified, experienced spine surgeons before making up your mind. To me, it sounds a bit scary.

The questions I would want answered are:

Do we know whether there is any interaction between the BMP and Forteo?

(Would you be taking Forteo prior to the fusion and then stop once the fusion is complete? If not, I would be worried that the Forteo might have some impact on the way BMP grows and then turns itself off.)

Actually I just reread your post and I don't understand what the surgeon is planning to do. I only am familiar with the use of BMP to replace donor bone at the fusion site. I had a PEEK cage and BMP on a one level fusion at L4-L5 and had no problems...but I do know people whose life has become a living hell due to the use of BMP that overgrew the disc space, and in someone who almost died having it in a cervical fusion.

But you say the surgeon intends to give it to you in addition to the bone graft you will receive for the fusion? I don't understand this.

 
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Old 10-11-2012, 11:10 PM   #3
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Re: Forteo and BMP to fuse c1 c2?

I was looking through some of your old posts for some background information. I see someone recommended Dr. Hyun Bae at Cedars-Sinai. Did you ever have a consultation with him? It looks like he would be about as innovative as anyone you could find....

 
Old 10-12-2012, 06:03 AM   #4
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Re: Forteo and BMP to fuse c1 c2?

It seems almost all surgeons are using BMP now. Funny you say Dr. Bae because I saw him and he was also going to use BMP. I had seen another doctor at a very prestiges hospital to see what he would do. He said it's up to me...I can use hip bone or BMP. But he strongly recommended BMP. He said it's their gold standard. He would use a little of it in a sponge. The reason Forteo came up is because when he did an MRI of my hip he noticed I have very low bone density and was worried that the screws might come out from the surgery. He recommended that I take the Forteo and the BMP together. I too thought it might be too much but he was ok with it. He's the director of Neurosurgery at the spine center at a very well know hospital so it can't get higher than that. But I just feel so strange taking both too...it scares me too. He's just worried it might not fuse and he doesn't want to take a chance and need to go in again. They were going to use donner bone and synthetic bone.

Last edited by Jazzmine1212; 10-12-2012 at 06:09 AM.

 
Old 10-12-2012, 06:34 AM   #5
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Re: Forteo and BMP to fuse c1 c2?

I don't know that surgeon. I just noticed that someone had recommended him to you. I checked his education, training and research and thought he looked impressive. What did you think of him?

I still don't understand about the BMP....you wrote [I]He recommended that I take the Forteo and the BMP together.[/I]

This is what has me confused...it sounds like BMP is a medicine that you are going to take....rather than a biologic product that will be implanted into your spine right adjacent to the spinal cord. So, is it that you would have BMP as the bone graft and then take the Forteo in addition for two months...to be sure the bone graft is growing?

BMP may be the gold standard, but it seems to me that surgeons are really being very judicious in its use due to the huge number of law suits that are going forward, and the increasing number of people whose lives are being impacted negatively by its use.

I would just want to really understand whether the Forteo could cause the BMP to grow in an unpredictable manner....what is really known about this combination? There aren't any long term studies on Forteo and BMP hasn't been used all that long either. As I told you, I have BMP so this is a topic that concerns me, too.

 
Old 10-12-2012, 07:01 AM   #6
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Re: Forteo and BMP to fuse c1 c2?

Sorry that's what I meant. He would use the BMP on a graft when he goes in to fuse. He wants me to take the Forteo also to strengthen my bones and chances for a fusion. He said it would only be fore 2 months after the surgery to give it a better chance of fusing. I too am worried and my surgery is next Friday! I have to make a decision. Ultimatly it's up to me. I met with Bae but this was before we found out that I have osteoperosis. He said he would put cadaver bone with BMP. I'm so confused as to what to do. I'll ask him about the effects of both being used and risk of overgrowth, but I think he's going to say he's not worried. How was your BMP use? Did they use sponge or a cage? Do you live in Los Angeles too? Who was your surgeon?

 
Old 10-12-2012, 07:07 AM   #7
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Re: Forteo and BMP to fuse c1 c2?

No, I do not live in California. My BMP was used in a cage in my lumbar spine.

The problem is that your surgeon can only tell you what he knows to be true at this point in time. Since there is no history for Forteo, this really isn't telling you much.

Do you know if the surgeon is planning on going in from the front or back?

 
Old 10-12-2012, 07:11 AM   #8
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Re: Forteo and BMP to fuse c1 c2?

from the back

 
Old 10-12-2012, 07:53 AM   #9
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Re: Forteo and BMP to fuse c1 c2?

Here's a link to the original warning to surgeons from the FDA concerning the use of BMP:

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/ucm062000.htm

 
Old 10-12-2012, 08:00 AM   #10
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Re: Forteo and BMP to fuse c1 c2?

I have to have the surgery because I have instability of c1...I also have Osteoperosis. I am in my 30's with small kids. I have no clue on what to do. If you were me what would you use?

 
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