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Bone morphogenetic protein in adult spinal deformity surgery: a meta-analysis
Journal article   Open access   Peer reviewed

Bone morphogenetic protein in adult spinal deformity surgery: a meta-analysis

Gregory W Poorman, Cyrus M Jalai, Anthony Boniello, Nancy Worley, Shearwood McClelland, 3rd and Peter G Passias
European spine journal, v 26(8), pp 2094-2102
Aug 2017
DOI: https://doi.org/10.1007/s00586-016-4841-5
PMID: 28281003
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1007/s00586-016-4841-5View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Adult Bone Morphogenetic Protein 2 - therapeutic use Combined Modality Therapy Humans Orthopedic Procedures - methods Postoperative Complications - chemically induced Postoperative Complications - prevention & control Recombinant Proteins - therapeutic use Spinal Curvatures - therapy Transforming Growth Factor beta - therapeutic use Treatment Outcome
Since its introduction BMP has been utilized in populations with higher rates of malunion, such as adult spinal deformity (ASD) patients. Contradictory conclusions exist in spinal literature regarding the safety and efficacy of the use of BMP in this setting. Previous studies, however, did not distinguish deformity cases from spondylolisthesis or stenosis. The purpose of this study is to evaluate the safety and efficacy of BMP use in spinal fusion surgery for ASD. 166 papers were screened after database search. 40 full texts were assessed for eligibility. Five studies were included for meta-analysis. Three were comparative studies between a BMP and non-BMP group, and the other was used to supplement dose-effect analysis. The current meta-analysis found increased odds of developing radiculitis or neurological complications (OR = 2.18, 95% CI, p = 0.02, i  = 0), but no other significant relationship between complications commonly attributed to BMP use (tumorigenesis, infections, seroma formation, or osteolysis) and BMP use. BMP patients had decreased rates of pseudarthrosis (OR = 0.23, 95% CI, p = 0.002, i  = 0). There was an average dose of 8.75 mg/level in the 417 patients studied, lower than the advised dosage of 12 mg/level. The current literature shows BMP to be a safe and effective grafting technique in the treatment of ASD. Spine surgeons may currently be using sub-optimal doses of BMP. The benefit of increasing the rate of fusion must be weighed against the increased risk of radiculitis and neurologic complications in this patient population.

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27 citations in Web of Science
27 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Orthopedics
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