The Posterior Use of BMP-2 in Cervical Deformity Surgery Does Not Result in Increased Early Complications: A Prospective Multicenter Study

Sravisht Iyer, Han Jo Kim, Hongda Bao, Justin S. Smith, Munish Gupta, Todd J. Albert, Themistocles S. Protopsaltis, Gregory M. Mundis, Peter Passias, Brian J. Neuman, Eric Otto Klineberg, Virginie Lafage, Christopher P. Ames

Research output: Contribution to journalArticle

Abstract

Study Design: Prospective cohort study. Objectives: To describe the rate of short-term complications following the posterior use of recombinant human bone morphogenetic protein–2 (rhBMP-2) in cervical deformity (CD) surgery. Methods: CD patients from 2013 to 2015 were enrolled in a prospective, multicenter database. Patients were divided into those receiving rhBMP-2 (BMP) and no rhBMP-2 (NOBMP). The relationship between BMP use, demographic variables surgical variables, radiographic parameters and complications was evaluated. Results: A total of 100 patients (47 BMP, 53 NOBMP) were included. Follow-up time averaged 7.6 months (range 3-12 months). An average of 13.6mg of BMP was used per person with 1.49 mg per level. Compared with the NOBMP group, patients in the BMP group were older (P =.03). BMP was more commonly used in patients that and had longer prior fusions (6.0 vs 2.5, P <.01). There were no differences between groups with regards to a history of surgery, Charlson Comorbidity Index, estimated blood loss, operation time, fusion levels, and surgical approach. The maintenance of radiographic parameters at 6-month follow-up was similar. There were no differences in terms of total complication incidence, total complications per person, major complications per person or any specific complication. Linear regression and Pearson correlation analysis did not reveal any strong r2 values (r2 = 0.09, 0.08, 0.06) between the use of BMP and complications (major or operative). Conclusions: BMP use was not directly associated with an increased incidence of early complications in this prospective cohort of operative adult CD patients. Its use was associated with increased number of levels instrumented and fused.

Original languageEnglish (US)
Pages (from-to)622-628
Number of pages7
JournalGlobal Spine Journal
Volume8
Issue number6
DOIs
StatePublished - Sep 1 2018

Fingerprint

Multicenter Studies
Prospective Studies
Bone and Bones
Incidence
Comorbidity
Linear Models
Cohort Studies
Maintenance
Demography
Databases

Keywords

  • adult spinal deformity
  • BMP
  • cervical deformity
  • complications
  • dysphagia
  • recombinant human bone morphogenetic protein–2 (rhBMP-2)

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

The Posterior Use of BMP-2 in Cervical Deformity Surgery Does Not Result in Increased Early Complications : A Prospective Multicenter Study. / Iyer, Sravisht; Kim, Han Jo; Bao, Hongda; Smith, Justin S.; Gupta, Munish; Albert, Todd J.; Protopsaltis, Themistocles S.; Mundis, Gregory M.; Passias, Peter; Neuman, Brian J.; Klineberg, Eric Otto; Lafage, Virginie; Ames, Christopher P.

In: Global Spine Journal, Vol. 8, No. 6, 01.09.2018, p. 622-628.

Research output: Contribution to journalArticle

Iyer, S, Kim, HJ, Bao, H, Smith, JS, Gupta, M, Albert, TJ, Protopsaltis, TS, Mundis, GM, Passias, P, Neuman, BJ, Klineberg, EO, Lafage, V & Ames, CP 2018, 'The Posterior Use of BMP-2 in Cervical Deformity Surgery Does Not Result in Increased Early Complications: A Prospective Multicenter Study', Global Spine Journal, vol. 8, no. 6, pp. 622-628. https://doi.org/10.1177/2192568218760538
Iyer, Sravisht ; Kim, Han Jo ; Bao, Hongda ; Smith, Justin S. ; Gupta, Munish ; Albert, Todd J. ; Protopsaltis, Themistocles S. ; Mundis, Gregory M. ; Passias, Peter ; Neuman, Brian J. ; Klineberg, Eric Otto ; Lafage, Virginie ; Ames, Christopher P. / The Posterior Use of BMP-2 in Cervical Deformity Surgery Does Not Result in Increased Early Complications : A Prospective Multicenter Study. In: Global Spine Journal. 2018 ; Vol. 8, No. 6. pp. 622-628.
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AU - Kim, Han Jo

AU - Bao, Hongda

AU - Smith, Justin S.

AU - Gupta, Munish

AU - Albert, Todd J.

AU - Protopsaltis, Themistocles S.

AU - Mundis, Gregory M.

AU - Passias, Peter

AU - Neuman, Brian J.

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N2 - Study Design: Prospective cohort study. Objectives: To describe the rate of short-term complications following the posterior use of recombinant human bone morphogenetic protein–2 (rhBMP-2) in cervical deformity (CD) surgery. Methods: CD patients from 2013 to 2015 were enrolled in a prospective, multicenter database. Patients were divided into those receiving rhBMP-2 (BMP) and no rhBMP-2 (NOBMP). The relationship between BMP use, demographic variables surgical variables, radiographic parameters and complications was evaluated. Results: A total of 100 patients (47 BMP, 53 NOBMP) were included. Follow-up time averaged 7.6 months (range 3-12 months). An average of 13.6mg of BMP was used per person with 1.49 mg per level. Compared with the NOBMP group, patients in the BMP group were older (P =.03). BMP was more commonly used in patients that and had longer prior fusions (6.0 vs 2.5, P <.01). There were no differences between groups with regards to a history of surgery, Charlson Comorbidity Index, estimated blood loss, operation time, fusion levels, and surgical approach. The maintenance of radiographic parameters at 6-month follow-up was similar. There were no differences in terms of total complication incidence, total complications per person, major complications per person or any specific complication. Linear regression and Pearson correlation analysis did not reveal any strong r2 values (r2 = 0.09, 0.08, 0.06) between the use of BMP and complications (major or operative). Conclusions: BMP use was not directly associated with an increased incidence of early complications in this prospective cohort of operative adult CD patients. Its use was associated with increased number of levels instrumented and fused.

AB - Study Design: Prospective cohort study. Objectives: To describe the rate of short-term complications following the posterior use of recombinant human bone morphogenetic protein–2 (rhBMP-2) in cervical deformity (CD) surgery. Methods: CD patients from 2013 to 2015 were enrolled in a prospective, multicenter database. Patients were divided into those receiving rhBMP-2 (BMP) and no rhBMP-2 (NOBMP). The relationship between BMP use, demographic variables surgical variables, radiographic parameters and complications was evaluated. Results: A total of 100 patients (47 BMP, 53 NOBMP) were included. Follow-up time averaged 7.6 months (range 3-12 months). An average of 13.6mg of BMP was used per person with 1.49 mg per level. Compared with the NOBMP group, patients in the BMP group were older (P =.03). BMP was more commonly used in patients that and had longer prior fusions (6.0 vs 2.5, P <.01). There were no differences between groups with regards to a history of surgery, Charlson Comorbidity Index, estimated blood loss, operation time, fusion levels, and surgical approach. The maintenance of radiographic parameters at 6-month follow-up was similar. There were no differences in terms of total complication incidence, total complications per person, major complications per person or any specific complication. Linear regression and Pearson correlation analysis did not reveal any strong r2 values (r2 = 0.09, 0.08, 0.06) between the use of BMP and complications (major or operative). Conclusions: BMP use was not directly associated with an increased incidence of early complications in this prospective cohort of operative adult CD patients. Its use was associated with increased number of levels instrumented and fused.

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KW - cervical deformity

KW - complications

KW - dysphagia

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