Assessment of Bone Growth Stimulator Is Mixed

It's used more often in spinal fusions, but experts worry about costs and complications

U.S.News & World Report—June 30, 2009

A relatively new agent that stimulates the creation of new bone as part of spinal fusion surgery is being increasingly used in the United States, although costs and some complication rates also appear to be higher with its use, a new study reports.

The therapeutic agent, known as bone-morphogenic protein, or BMP, is now used in at least 25 percent of spinal fusion surgeries.

A study,  which is in the July 1 issue of the Journal of the American Medical Association, found that more complications occurred in procedures involving the front part of the neck - anterior cervical fusions - when BMP was used.

The study did not find an increase in complications in other fusion procedures.

Nonetheless, other surgical experts expressed the need for caution.

"You need to have a reason to use BMP," said Dr. Frank P. Cammisa Jr., chief of spinal surgery at Hospital for Special Surgery in New York City. "If there are risk factors or it's a revision surgery, then use it. But, you really need to have a good reason to use it."

Cammisa also pointed out that the study did not find shorter lengths of stay for procedures with BMP and did not look at outpatient complications, which he said might be increased.

"I think [this study] serves as an impetus for surgeons to look for less expensive, but efficacious, bone growth factors other than BMP," he said. Also, Cammisa said, he'd like to see specific guidelines developed for the use of BMP.

The surgeon agreed that more research is needed to determine who is an ideal candidate for BMP use and to assess the costs and benefits of the therapy.

Read the full story at usnews.com.