48 A 48-year-old woman presents with mechanical low back pain and a history of an L3-S1 pedicle screw fusion as well as L4-L5, L5-S1 interbody fusion. Dynamic films show instability across L4-L5 and L5-S1, indicating the development of nonunion. As seen on axial computed tomography (CT) myelogram, there are soft tissue filling defects, likely due to postoperative fibrosis, at L4-L5 and L5-S1. Transverse process bony formation was minimal (Fig. 48-1). Lumbar instability Redo lumbar spinal fusion with bone morphogenetic protein.
Bone Morphogenetic Protein
Presentation
Radiologic Findings
Diagnosis
Treatment
Discussion
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