Use of Recombinant Human Bone Morphogenetic Protein-2 in the Treatment of Degenerative Spondylolisthesis. Issue 5 (March 2016)

• Record Type: Journal Article
• Authors: Schroeder, Gregory D.; Hsu, Wellington K.; Kepler, Christopher K.; Kurd, Mark F.; Vaccaro, Alexander R.; Patel, Alpesh A.; Savage, Jason W.
• Is Part Of: Spine. Volume 41:Issue 5(2016)
• Publication Date: 2016-03
• Subjects: bone morphogenetic protein -- degenerative spondylolisthesis -- low back pain -- lumbar fusion -- Lumbar Spine Research Society -- rhBMP-2; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000001228
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: A questionnaire survey. Objective: To report the current use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in lumbar fusion procedures for the treatment of degenerative spondylolisthesis (DS), and identify associated factors including fusion technique, surgeon location, surgeon specialty, or surgeon practice model. Summary of Background Data: The prevalence of rhBMP-2 use in fusions increased dramatically from 0.7% in 2002 to 24.7% in 2006, however more recent studies have identified significant complications with its use. Furthermore, an independent review of the industry-sponsored trial data has demonstrated no significant difference in fusion rates or clinical results with the use of rhBMP-2 compared with iliac-crest autograft. Methods: In July 2014, a survey was sent requesting information on the usage of rhBMP-2 in the treatment of DS. Determinants included the fusion technique, geographic location, specialty, and associated practice models. No funding was received for this work. Results: Overall, 7.8% +/− 2.0% of surgeons reported using rhBMP-2 when performing an open L4-L5 posterolateral fusion for DS; 6.2% +/− 1.8% reported using rhBMP-2 for an open L4-L5 interbody fusion, and 12.1% +/− 2.5% reported using rhBMP-2 for a L4-L5 minimally invasive (MIS) interbody fusion. The variables that were statistically associated with the use of rhBMP-2 were North America surgeons ( P < 0.0001) and the type of procedure ( P = 0.0005). Conclusion: Compared with historical data, there has been a dramatic decrease in the number of surgeons using rhBMP-2 in lumbar fusion procedures for the treatment of DS. Currently, rhBMP-2 is more commonly used by surgeons in North America and those performing MIS interbody fusions. Level of Evidence: N/A Abstract : Supplemental Digital Content is available in the text