Since FDA approved rhBMP-2 for treating degenerative disc disease, surgeons have expanded its use for other off-label procedures resulting in an increasing number of complications. Among the complications are neurological complications that were not reported during the early application of rhBMP-2. Early work indicated little morbidity on neurological tissues. In-vivo studies indicated that rhBMP-2 triggers signaling response in nerve cells within the spinal cord and peripheral ganglia. Preclinical studies indicated that rhBMP-2 could trigger significant inflammation and morphologic changes within these tissues that could be detrimental to neurologic recovery. Certain other reports have demonstrated penetration of rhBMP-2 activates a signaling cascade in all major central nervous system cell types.
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