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.

Lumbar Spinal Fusion Using Recombinant Human Bone Morphogenetic Protein in the Canine

Spine ◽  
1999 ◽  
Vol 24 (19) ◽  
pp. 1973 ◽  
Author(s):  
Stephen M. David ◽  
Helen E. Gruber ◽  
Ralph A. Meyer ◽  
Takanori Murakami ◽  
Owen B. Tabor ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Bone Morphogenetic Protein ◽  
Human Bone ◽  
Lumbar Spinal Fusion ◽  
Morphogenetic Protein ◽  
Human Bone Morphogenetic Protein ◽  
Lumbar Spinal ◽  
Recombinant Human Bone

scholarly journals Evaluation of ultrasound-guided lateral thoracolumbar interfascial plane block for postoperative analgesia in lumbar spine fusion surgery: a prospective, randomized, and controlled clinical trial

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7967 ◽  
Author(s):  
Ke Chen ◽  
Lizhen Wang ◽  
Meng Ning ◽  
Lianjie Dou ◽  
Wei Li ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Fusion ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Single Shot ◽  
Lumbar Spinal Fusion ◽  
Ultrasound Guided ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Lumbar Spinal

Objective Ultrasound-guided lateral thoracolumbar interfascial plane block (US-TLIP block) is a novel regional technique for anesthesia or analgesia. However, there has been no prospective, randomized and controlled clinical trial investigating the perioperative analgesic effect of US-TLIP block on lumbar spinal fusion surgery. The aim of this study was to investigate the analgesic effect of bilateral single-shot US-TLIP in patients undergoing lumbar spinal fusion surgery. Methods A prospective and randomized comparative clinical study was conducted. A total of 60 patients (ASA classes: I–II), aged 21–74 years who were scheduled for lumbar spinal fusion surgery were randomized and divided into the TLIP group (Group T, n = 30) and control group (Group C, n = 30). The patients in Group T received preoperative bilateral single-shot US-TLIP with 30 ml of 0.375% ropivacaine at the third lumbar spine (L3) vertebral level, and the patients in Group C received an injection of 30 ml 0.9% saline through same technique. All patients received patient-controlled analgesia (PCA) after their operation. The frequency of PCA compressions and rescue analgesic administrations were recorded. Opioids (sufentanil and remifentanil), anesthetic consumption, the number of postoperative days spent in a hospital bed, overall hospital stay time and postoperative complications were recorded. The Visual Analogue Scale (VAS) and Bruggemann Comfort Scale (BCS) scores for pain and comfort assessment were recorded at 1, 12, 24, 36, and 48 hours postoperatively. Results Opioids and anesthetic consumption in the perioperative period decreased significantly in the TLIP group compared to the control group (P < 0.05). The VAS and BCS scores in the TLIP group were lower at 12, 24, and 36 hours postoperatively (P < 0.05). US-TLIP block has been shown to shorten postoperative hospital stays (P < 0.05). There was no significant difference in postoperative complications between the two groups. Conclusion Our study findings show that bilateral US-TLIP block exhibits significant analgesia and safety in patients undergoing lumbar spinal fusion surgery.

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