Use of bone morphogenetic protein in lumbar fusion may yield high risk profile
Use of bone morphogenetic protein in single-level lumbar fusion may have a higher risk profile than previously reported with non-significant benefits, according to results.
Rown Parola, MS, and colleagues categorized 362,530 Medicare patients who underwent single-level lumbar fusion between 2004 and 2014 into groups based on whether they received bone morphogenetic protein (BMP).
“The demographics and comorbidities were also identified by ICD-9 diagnosis code, and then we underwent propensity matching, trying to match our cohorts along the basis of age, Elixhauser comorbidity index, sex, region, treatment year, smoking status, osteoporotic status and nutritional status,” Parola said in his presentation at the Lumbar Spine Research Society Annual Meeting.
Parola noted patients who received BMP experienced significantly more instances of implant complications, ileus, all-cause 30-day readmission, pseudoarthrosis and pseudoarthrosis requiring revision compared with patients who did not receive BMP.
“We also saw length of stay was significantly less in the BMP cohort,” Parola said. “This may not be a clinically significant finding, at roughly a 5-hour difference.”
Patients who received BMP had significantly increased odds of pseudoarthrosis, pseudoarthrosis requiring revision, all cause 30-day readmission and implant complications, according to Parola.
“This is specifically in the cases of pseudoarthrosis and pseudoarthrosis treated for revision, what we are trying to avoid by using BMP,” Parola said. “Seeing a higher likelihood of these complications calls to question the use of BMP in single-level lumbar fusion.”
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Syed K, et al. Paper 14. Presented at: Lumbar Spine Research Society Annual Meeting; Nov. 12-15, 2020 (virtual meeting).