A Protein Used in Spine Surgeries May Increase Complications

Arthritis Today—July 13, 2009   

A new study finds that a bone protein used in thousands of spinal fusion surgeries is linked to complications when it is used in the neck and more expensive hospital charges in all categories of spinal fusions.

This is the first nationwide study of bone-morphogenetic protein, or BMP, which the Food and Drug Administration approved in 2002 for back surgeries but not for spinal fusions in the neck.

Frank P. Cammisa, Jr., MD, is Chief of the Spinal Surgical Service at Hospital for Special Surgery in New York City. He says this study is important because it’s the first to look at national patterns of use of BMP. But he says his concern is that the study doesn’t look at long-term complications and doesn’t compare costs over the long term. “Short term obviously the hospital costs are increased,” Dr. Cammisa says. “However, long term, if the use of BMP results in a higher fusion rate, there may be less need for revision surgeries in the future and therefore it would be a bottom line decrease in cost; as a result we need more longitudinal data to determine its cost effectiveness.”

Dr. Cammisa says in the future it would be nice to see a study of dosing, so surgeons have a better idea of how much is necessary to increase the fusion rate, while decreasing the complications rate. And he agrees that it would be nice to get more specific guidelines for its use while also looking at long-term risks and benefits.

Read the full story at arthritistoday.org.