Browsing by Author "Mobasser, Jean-Pierre"

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    De Novo Plasmacytoma at the Site of Previous Anterior Cervical Fusion
    (Wolters Kluwer, 2023-12-07) Burket, Noah J.; Mobasser, Dillon C.; Alentado, Vincent J.; Mobasser, Jean-Pierre; Neurological Surgery, School of Medicine
    Background and importance: Solitary plasmacytoma of bone (SPB) is a rare tumor that forms from monoclonal plasma cells within bone. These tumors are typically found in patients in their fifth to sixth decade of life and often progress to multiple myeloma. Previous reports have noted the formation of these tumors at the site of previous procedures or trauma, yet none have reported the development of SPB at the same site of a previous spinal surgery. Clinical presentation: The authors report on a 47-year-old woman who developed a de novo plasmacytoma 6 years after anterior cervical discectomy and fusion at the surgical site. Conclusion: Although SPB is a rare tumor primarily seen in bone that has been unaffected by surgery, it should be included in the differential after finding a tumor at the site of a previous spine surgery. Furthermore, biopsy should be considered once a lesion is identified in the area of a previous spine surgery, as SPB may progress to multiple myeloma, resulting in worse outcomes.
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    The Use of Bone Morphogenetic Protein in the Intervertebral Disk Space in Minimally Invasive Transforaminal Lumbar Interbody Fusion
    (Wolters Kluwer, 2019-07) White, Ian K.; Tuohy, Megan; Archer, Jacob; Schroeder, Gregory D.; Vaccaro, Alexander R.; Mobasser, Jean-Pierre; Neurological Surgery, School of Medicine
    Study Design: Retrospective Cohort. Objective: The objective of this study was to characterize one surgeon’s experience over a 10-year period using rhBMP-2 in the disk space for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Summary of Background Data: MIS TLIF has been utilized as a technique for decreasing patients’ immediate postoperative pain, decreasing blood loss, and shortened hospital stays. Effectiveness and complications of rhBMP-2’s use in the disk space is limited because of its off-label status. Methods: Retrospective analysis of consecutive MIS TLIFs performed by senior author between 2004 and 2014. rhBMP-2 was used in the disk space in all cases. Patients were stratified based on the dose of rhBMP-2 utilized. Patients had 9 to 12 month computerized tomography scan to evaluate for bony fusion and continued follow-up for 18 months. Results: A total of 688 patients underwent a MIS TLIF. A medium kit of rhBMP-2 was utilized in 97 patients, and small kit was used in 591 patients. Fusion rate was 97.9% and this was not different between the 2 groups with 96/97 patients fusing in the medium kit group and 577/591 patients fusing in the small kit group. Five patients taken back to the operating room for symptomatic pseudoarthrosis, 4 reoperated for bony hyperostosis, and 10 radiographic pseudoarthroses that did not require reoperation. A statistically significant difference in the rate of foraminal hyperostosis was found when using a medium sized kit of rhBMP-2 was 4.12% (4/97 patients), compared with a small kit (0/591 patients, P=0.0004). Conclusions: Utilization of rhBMP-2 in an MIS TLIF leads to high fusion rate (97.9%), with an acceptable complication profile. The development of foraminal hyperostosis is a rare complication that only affected 0.6% of patients, and seems to be a dose related complication, as this complication was eliminated when a lower dose of rhBMP-2 was utilized.