Use of Bone Morphogenetic Protein-2 in Vertebral Column Tumor Surgery: A National Investigation.

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Use of Bone Morphogenetic Protein-2 in Vertebral Column Tumor Surgery: A National Investigation.

World Neurosurg. 2018 May 04;:

Authors: De la Garza Ramos R, Nakhla J, Echt M, Gelfand Y, Altschul DJ, Cho W, Kinon MD, Yassari R

Abstract
OBJECTIVE: To report the rate of bone morphogenetic protein-2 (BMP-2) use in vertebral column tumor surgery.
METHODS: The Nationwide Inpatient Sample database (2012-2014) was queried to identify patients who underwent spinal fusion for vertebral column tumors (primary benign, primary malignant, or metastatic). The rate of BMP-2 use was calculated and patient/operative factors associated with its use were also investigated.
RESULTS: A total of 9,375 patients who underwent fusion surgery for spinal tumors between 2012 and 2014 were identified, with 540 cases using BMP-2 (5.8%). Based on preoperative diagnosis, the rate of BMP-2 use in primary benign tumor surgery was 4.9%, 7.6% for primary malignant tumors, and 5.7% for metastatic lesions (p-value 0.607). The overall complication rate was 13.2% (13.4% in the NO-BMP-2 group vs. 11.1% in the BMP-2 group (p=0.504). Patients who received this growth factor were less likely to have epidural spinal cord compression at presentation (37.0% vs. 49.2%, p=0.014), and more likely to have elective surgery (53.7% vs. 37.7%, p<0.001). Based on hospital location, the highest usage of BMP-2 was in the South (7.4% rate, p=0.002). There was no statistical difference between age, sex, insurance status, co-morbidities, the presence of a pathological fracture, or the use of inpatient radio/chemotherapy between patients who received BMP-2 and controls.
CONCLUSION: BMP-2 has been used off-label to promote arthrodesis; however, its use on patients with spinal tumors is controversial. In this national study, BMP-2 use was highest in the South, in patients without epidural cord compression at presentation, and in elective cases.

PMID: 29733987 [PubMed - as supplied by publisher]

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