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Dose of rhBMP-2 in spine deformity surgery not associated with major complications
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DALLAS — Recombinant human bone morphogenetic protein-2 (rhBMP-2) was not associated with wound, superficial or deep infections in a study of adults treated for spinal deformity. Its use, however, did correlate to increases in minor complications compared to a group of patients not that did not receive rhBMP-2, according to a recent study presented at the North American Spine Society Meeting, here.
“Looking at complications associated with BMP use in spinal deformity, the kind of results depend on how you analyze the data,” R. Shay Bess, MD, said in his presentation. “In simplistic analysis, BMP had more total minor complications. The two [groups] were similar in wound, deep infection [and] neurological onset.”
Bess, who is at the Rocky Mountain Scoliosis and Spine Center in Denver, presented the results.
He and colleagues collected data for 257 consecutive adults undergoing surgery to correct spinal deformity for their prospective multicenter study that compared patients that received rhBMP-2 to patients who did not receive the bone graft substitute.
Using multivariate and regression analyses, Bess and colleagues determined complication types, rates of major and minor complications, complications that required surgery, and any correlation between total rhBMP-2 dose and levels treated. The average follow-up was 20.3 months.
Per patient, the rhBMP-2 group had more complications, higher Charlson comorbidity index scores, longer operative times, more osteotomies per patient, and increased anteroposterior surgery rates than the non-rhBMP-2 group. However, the major complications, neurological and wound complications, superficial and deep infections, and complications needing surgery were similar between the groups, Bess said.
The posterior rhBMP-2 dose was associated with total major and neurological complications, he said, but r values showed the correlations were small.
“Clearly, future research should focus on more consistent and advanced data analysis, long-term complications and then, more importantly, the health-related quality of life years,” Bess said.
Reference:
Bess RS. Paper #10. Presented at: North American Spine Society Annual Meeting. Oct. 24-27, 2012; Dallas.
Disclosure: Bess receives royalties from Pioneer, is a consultant to Allosource, DePuy Spine and Medtronic, has a speaking/ teaching arrangements with DePuy Spine, travels for DePuy Spine and Medtronic, is on the Scientific Advisory Board for Allosource, receives research support from DePuy Spine and grants from Orthopaedic Research and Education Foundation.
