Mimally invasive TLIF w/Hydrocision (interesting BMP data too)

[Tim]

Thanks for posting this interesting article.
The 22% figure for late onset radiculopathy in the BMP group is very worrying. It’s the worst figure I’ve seen regarding complications relating to BMP use in lumbar fusions and if taken at face value must seriously call into question the current increasing use of BMP. When I questioned one surgeon regarding this issue he stated that in his opinion a lot of problems with BMP are caused by surgeon error – by which I suppose he meant incorrect placement of the BMP within the prepared disc space. I suppose it makes sense that if the majority of the BMP material is packed to the front of the disc space then the risk of overgrowth is minimised. My understanding is probably oversimplified but it would be nice if more data were available to fully understand the level of complications associated with BMP.
The hydrocision apparatus sounds very promising – how long has it been around and how established is it’s usage in current operating theatres?
All the best
Tim

[mmglobal]

Originally Posted by Tim

The 22% figure for late onset radiculopathy in the BMP group is very worrying. It’s the worst figure I’ve seen regarding complications relating to BMP use in lumbar fusions and if taken at face value must seriously call into question the current increasing use of BMP.

This is the problem with so much of the data we get. Is BMP a problem or is this application a problem? Don't go to those docs for BMP??? Is there something specific about this technique that makes appropriate application of BMP an issue?

[Maria]

Thanx Mark. Don't know what to think except once again I'm glad to date I didn't become a personal recipient of BMP.

[mmglobal]

When I started looking at this, I found a press release from 2006 that talks about Stan Schiffer being the most experienced hydrocision user at the time. He called me today and we spent about 1/2 hour discussing the state of spine, including hydrocision. He still uses it, but for discectomy, not fusion prep. What he does is much different than the 'normal' use, but he likes the system and gets excellent results with it. I asked how many cases he'd done with hydrocision and he's stopped counting. "Hundreds and hundreds was his reply." The press relase talked about 100 cases more than 2 years ago.

It's been a while since we'd spoken, so it was great to catch up with him. We met at my first spine conference in 2002 and he's been very helpful to me and many of my clients since then. He's a pioneer in Minimally Invasive Spine Surgery and I've been up to see him do surgery (cervical and lumbar) several times. Nice guy... good surgeon. It's interesting that the recent seminar brings me back to one of the first doctors I'd met in my new life after my surgery.

[jsewell]

Thanks Mark for posting and explaining this, it is very interesting
judy

[Maria]

any updates Mark?

[mmglobal]

I just texted one of the study authors... I'll let you know if I hear anything interesting.

Mark