Concern over the use of recombinant bone morphogenetic protein in spinal fusion surgery: are stem cells an alternative?

2014 ◽  
Vol 84 (5) ◽  
pp. 302-303
Author(s):  
David Oehme ◽  
Tony Goldschlager ◽  
Peter Ghosh ◽  
Graham Jenkin ◽  
Jeffrey V. Rosenfeld
Keyword(s):  
Stem Cells ◽  
Spinal Fusion ◽  
Bone Morphogenetic Protein ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Morphogenetic Protein

scholarly journals Application of Bone Morphogenetic Protein in Spinal Fusion Surgery

2021 ◽  
Author(s):  
Siavash Beiranvand ◽  
Farshad Hasanzadeh-Kiabi
Keyword(s):  
Spinal Fusion ◽  
Bone Morphogenetic Protein ◽  
Bone Morphogenetic Protein 2 ◽  
Iliac Crest Bone Graft ◽  
Comprehensive Overview ◽  
Fusion Surgery ◽  
Safety Issues ◽  
Spinal Fusion Surgery ◽  
Morphogenetic Protein ◽  
Human Bone Morphogenetic Protein

Lumbar and cervical fusions are one of the most common types of spine surgeries performed globally with approximated 450,000 spinal fusion surgeries performed annually. (give reference) Bone Morphogenetic Proteins (BMPs) are secreted cytokines with several functions, within the TGF-b superfamily. BMP act as a disulfide-linked homo- or heterodimers and have been recognized as strong and effective regulators of important biological processes like formation and repair of osteocytes and chondrocytes, cell proliferation during embryonic development. Recombinant human bone morphogenetic protein 2 (rhBMP-2) is a very effective osteogenic growth factor that has been demonstrated to be effective in different types of spinal fusions and reduces the reliance on the use autologous iliac crest bone graft. In recent years there have been limitations regarding the use of rhBMP-2 because of issues like high costs, benefits, and safety issues about rhBMP-2. In this review, a comprehensive overview about the application of rhBMP-2 in spinal fusion surgery is given.

scholarly journals A comprehensive assessment of the risk of bone morphogenetic protein use in spinal fusion surgery and postoperative cancer diagnosis

2015 ◽  
Vol 23 (1) ◽  
pp. 86-93 ◽  
Author(s):  
Kevin S. Cahill ◽  
Paul C. McCormick ◽  
Allan D. Levi
Keyword(s):  
Spinal Fusion ◽  
Bone Morphogenetic Protein ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Open Data ◽  
Data Access ◽  
Conclusive Evidence ◽  
Spinal Fusion Surgery ◽  
Cancer Occurrence ◽  
Morphogenetic Protein

The risk of postoperative cancer following the use of recombinant human bone morphogenetic protein (BMP)–2 in spinal fusion is one potential complication that has received significant interest. Until recently, there has been little clinical evidence to support the assertion of potential cancer induction after BMP use in spinal surgery. This report aims to summarize the findings from clinical data available to date from the Yale University Open Data Access (YODA) project as well as more recently published large database studies regarding the association of BMP use in spinal fusion and the risk of postoperative cancer. A detailed review was based on online databases, primary studies, FDA reports, and bibliographies of key articles for studies that assessed the efficacy and safety of BMP in spinal fusion. In an analysis of the YODA project, one meta-analysis detected a statistically significant increase in cancer occurrence at 24 months but not at 48 months, and the other meta-analysis did not detect a significant increase in postoperative cancer occurrence. Analysis of 3 large health care data sets (Medicare, MarketScan, and PearlDiver) revealed that none were able to detect a significant increase in risk of malignant cancers when BMP was used compared with controls. The potential risk of postoperative cancer formation following the use of BMP in spinal fusion must be interpreted on an individual basis for each patient by the surgeon. There is no conclusive evidence that application of the common formulations of BMP during spinal surgery results in the formation of cancer locally or at a distant site.

Ex Vivo Bone Morphogenetic Protein-9 Gene Therapy Using Human Mesenchymal Stem Cells Induces Spinal Fusion in Rodents

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1239-1245 ◽  
Author(s):  
Randall J. Dumont ◽  
Hayan Dayoub ◽  
Jin Zhong Li ◽  
Aaron S. Dumont ◽  
David F. Kallmes ◽  
...  
Keyword(s):  
Stem Cells ◽  
Gene Therapy ◽  
Mesenchymal Stem Cells ◽  
Spinal Fusion ◽  
Bone Morphogenetic Protein ◽  
Ex Vivo ◽  
Human Mesenchymal Stem Cells ◽  
Morphogenetic Protein ◽  
Bone Morphogenetic Protein 9

scholarly journals A population-based review of bone morphogenetic protein: associated complication and reoperation rates after lumbar spinal fusion

2015 ◽  
Vol 39 (4) ◽  
pp. E13 ◽  
Author(s):  
Jason W. Savage ◽  
Mick P. Kelly ◽  
Scott A. Ellison ◽  
Paul A. Anderson
Keyword(s):  
Spinal Fusion ◽  
Bone Morphogenetic Protein ◽  
Complication Rate ◽  
Large Scale ◽  
Population Based ◽  
Control Group ◽  
Lumbar Spinal Fusion ◽  
Spinal Fusion Surgery ◽  
Morphogenetic Protein ◽  
Lumbar Spinal

OBJECT The authors compared the rates of postoperative adverse events and reoperation of patients who underwent lumbar spinal fusion with bone morphogenetic protein (BMP) to those of patients who underwent lumbar spinal fusion without BMP. METHODS The authors retrospectively analyzed the PearlDiver Technologies, Inc., database, which contains the Medicare Standard Analytical Files, the Medicare Carrier Files, the PearlDiver Private Payer Database (UnitedHealthcare), and select state all-payer data sets, from 2005 to 2010. They identified patients who underwent lumbar spinal fusion with and without BMP. The ICD-9-CM code 84.52 was used to identify patients who underwent spinal fusion with BMP. ICD-9-CM diagnosis codes identified complications that occurred during the initial hospital stay. ICD-9-CM procedural codes were used to identify reoperations within 90 days of the index procedure. The relative risks (and 95% CIs) of BMP use compared with no BMP use (control) were calculated for the association of any complication with BMP use compared with the control. RESULTS Between 2005 and 2010, 460,773 patients who underwent lumbar spinal fusion were identified. BMP was used in 30.7% of these patients. The overall complication rate in the BMP group was 18.2% compared with 18.7% in the control group. The relative risk of BMP use compared with no BMP use was 0.976 (95% CI 0.963–0.989), which indicates a significantly lower overall complication rate in the BMP group (p < 0.001). In both treatment groups, patients older than 65 years had a statistically significant higher rate of postoperative complications than younger patients (p < 0.001). CONCLUSIONS In this large-scale institutionalized database study, BMP use did not seem to increase the overall risk of developing a postoperative complication after lumbar spinal fusion surgery.

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