ABSTRACT
Benign tumors in the spine include osteoid osteoma, osteoblastoma, aneurysmal bone cyst, osteochondroma, neurofibroma, giant cell tumor of bone, eosinophilic granuloma, and hemangioma. Although some are incidental findings, some cause local pain, radicular symptoms, neurologic compromise, spinal instability, and deformity. The evaluation of spinal tumors includes a thorough history and physical examination, imaging, sometimes laboratory evaluation, and biopsy when indicated. Appropriate treatment may be observational (eg, eosinophilic granuloma) or ablative (eg, osteoid osteoma, neurofibroma, hemangioma), but generally is surgical, depending on the level of pain, instability, neurologic compromise, and natural history of the lesion. Knowledge of the epidemiology, common presentation, imaging, and treatment of benign bone tumors is essential for successful management of these lesions.
Subject(s)
Bone Neoplasms/diagnosis , Bone Neoplasms/therapy , Spinal Diseases/diagnosis , Spinal Diseases/therapy , Bone Cysts, Aneurysmal/diagnosis , Bone Cysts, Aneurysmal/therapy , Bone Neoplasms/pathology , Eosinophilic Granuloma/diagnosis , Eosinophilic Granuloma/therapy , Giant Cell Tumor of Bone/diagnosis , Giant Cell Tumor of Bone/therapy , Hemangioma/diagnosis , Hemangioma/therapy , Humans , Neurofibroma/diagnosis , Neurofibroma/therapy , Osteoblastoma/diagnosis , Osteoblastoma/therapy , Osteochondroma/diagnosis , Osteochondroma/therapy , Osteoma, Osteoid/diagnosis , Osteoma, Osteoid/therapy , Prognosis , Spinal Diseases/pathology , Treatment OutcomeABSTRACT
Bone morphogenic proteins (BMPs) are pleiotropic regulators of bone volume, skeletal organogenesis and bone regeneration after a fracture. They function as signaling agents to affect cellular events like proliferation, differentiation and extracellular matrix synthesis. Clinically utilized rhBMP-2 combines rhBMP-2 with an osteoconductive carrier to induce bone growth and acts as a bone graft substitute. rhBMP-2, initially released in 2002, has been used primarily in spinal fusions in the lumbar and cervical regions. Recently, the application of rhBMP-2 has extended into the orthopedic trauma setting with increased application in open tibia fractures. This review outlines the history of development, molecular characteristics, toxicity and clinical applications.
