Global Spine J 2016; 06(08): 749-755
DOI: 10.1055/s-0036-1580735
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Analysis of Recombinant Human Bone Morphogenetic Protein-2 Use in the Treatment of Lumbar Degenerative Spondylolisthesis

Qingqiang Yao1, 2, *, Jeremiah R. Cohen1, *, Zorica Buser3, Jong-Beom Park4, Darrel S. Brodke5, Hans-Joerg Meisel6, Jim A. Youssef7, Jeffrey C. Wang3, S. Tim Yoon8
  • 1Department of Orthopaedic Surgery, University of California, Los Angeles, California, United States
  • 2Department of Orthopaedic Surgery, Nanjing Medical University, Nanjing Hospital, Nanjing, China
  • 3Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
  • 4Department of Orthopaedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea School of Medicine, Uijongbu, Korea
  • 5Department of Orthopedics, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • 6Department of Neurosurgery, Bergmannstrost Hospital, Halle, Germany
  • 7Durango Orthopedic Associates, P.C./Spine Colorado, Durango, Colorado, United States
  • 8Department of Orthopedics, Emory Spine Center, Atlanta, Georgia
Further Information

Publication History

11 September 2015

02 February 2016

Publication Date:
25 March 2016 (eFirst)

Abstract

Study Design Retrospective database review.

Objective To identify trends of the recombinant human bone morphogenetic protein-2 (rhBMP-2) use in the treatment of lumbar degenerative spondylolisthesis (LDS).

Methods PearlDiver Patient Record Database was used to identify patients who underwent lumbar fusion for LDS between 2005 and 2011. The distribution of bone morphogenetic protein use rate (BR) in various surgical procedures was recorded. Patient numbers, reoperation numbers, BR, and per year BR (PYBR) were stratified by geographic region, gender, and age.

Results There were 11,335 fusion surgeries, with 3,461 cases using rhBMP-2. Even though PYRB increased between 2005 and 2008, there was a significant decrease in 2010 for each procedure: 404 (34.5%) for posterior interbody fusion, 1,282 (34.3%) for posterolateral plus posterior interbody fusion (PLPIF), 1,477 (29.2%) for posterolateral fusion, and 335 (22.4%) for anterior lumbar interbody fusion. In patients using rhBMP-2, the reoperation rate was significantly lower than in patients not using rhBMP-2 (0.69% versus 1.07%, p < 0.0001). Male patients had higher PYBR compared with female patients in 2008 and 2009 (p < 0.05). The West region and PLPIF had the highest BR and PYBR.

Conclusions Our data shows that the revision rates were significantly lower in patients treated with rhBMP-2 compared with patients not treated with rhBMP-2. Furthermore, rhBMP-2 use in LDS varied by year, region, gender, and type of fusion technique. In the West region, the posterior approach and patients 65 to 69 years of age had the highest rate of rhBMP-2 use.

* Qingqiang Yao and Jeremiah R. Cohen contributed equally.