Describe some potential disadvantages or concerns with use of rhBMP2 for spinal fusions

• Possibility of bone formation in ectopic sites separate from the area of intended fusion (e.g. within the spinal canal following transforaminal lumbar interbody fusion)

• Incomplete knowledge about optimal dose, carrier, and long-term follow-up of the procedure in humans

• Tissue swelling and edema (multiple reports regarding problems associated with use in anterior cervical spine due to delayed postoperative swelling and airway problems)

• Vertebral osteolysis and vertebral edema (may lead to misdiagnosis as infection or lead to cage/graft subsidence)

• Postoperative radiculitis without evidence of neural compression

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