Rapid Vertebral Osteolysis after Utilization of rhBMP-2

Recent concern regarding the safety of recombinant human bone morphogenetic protein-2 (BMP-2) in spine surgery has increased awareness of a possible broad spectrum of adverse sequelae of this biologic. However, the impact of BMP-2 on postoperative osteolysis in the setting of lateral lumbar interbody fusion needs to be comprehensively evaluated. Three cases of significant osteolysis within the vertebral body following lumbar surgery supplemented by BMP-2 are presented. A detailed overview of one of the three cases is expanded on for the reader. Despite multiple prior reports, the incidence and spectrum of adverse clinical sequelae related to BMP-2 in the setting of spinal fusion surgery remains to be fully elucidated. Reporting of this delayed complication attributable to BMP-2 use will add to current reports on BMP-2 safety and complications. This case report will increase awareness of the possibility of post-operative osteolysis due to BMP-2 utilization.