Saturday, 6 February 2016

Reoperation risk for pseudarthrosis decreased significantly with BMP use in fusion surgery

Researchers of this retrospective review found patients with adult spinal deformity who received bone morphogenetic protein-2 during their index spine surgery experienced a 7.5-fold decrease in the risk of reoperation for pseudarthrosis after long fusion.

Researchers used the 2008 to 2011 New York Inpatient Database and identified 3,751 patients who underwent spinal arthrodesis for adult spinal deformity (ASD). All patients were 21 years of age and older, had a diagnosis of scoliosis and had an index fusion of greater than two spinal motion segments.
A total of 37.6% of patients received bone morphogenetic protein-2 (BMP) at their initial visit. Posterior fusion cases longer than eight levels resulted in a 23.4% reoperation rate for pseudarthrosis. For ASD fusions greater than eight levels, patients who received BMP had a 5% reoperation rate for pseudarthrosis compared with a 33.9% reoperation rate for patients who did not receive BMP.
“Enhancing the host environment to achieving a multilevel spinal fusion in ASD patients with a biologic seems inherently beneficial. Studying the effects of BMP on multilevel fusion in 55 adult deformity patients, a retrospective analysis showed pseudarthrosis rates were about seven-fold higher in the [iliac crest-bone graft] ICBG group than in the BMP group,” researchers wrote in the study.
Researchers concluded the use of BMP greatly reduces reoperation rates due to pseudarthrosis, which may be cause by the improved long fusion mass needed for successful treatment of ASD. – by Robert Linnehan

Source : Healio , 2nd Feb 2016 

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