Use of Bone Morphogenetic Protein-2 in Vertebral Column Tumor Surgical procedure: A Nationwide Investigation.
World Neurosurg. 2018 Could 04;:
Authors: De la Garza Ramos R, Nakhla J, Echt M, Gelfand Y, Altschul DJ, Cho W, Kinon MD, Yassari R
OBJECTIVE: To report the speed of bone morphogenetic protein-2 (BMP-2) use in vertebral column tumor surgical procedure.
METHODS: The Nationwide Inpatient Pattern database (2012-2014) was queried to determine sufferers who underwent spinal fusion for vertebral column tumors (main benign, main malignant, or metastatic). The speed of BMP-2 use was calculated and affected person/operative elements related to its use had been additionally investigated.
RESULTS: A complete of 9,375 sufferers who underwent fusion surgical procedure for spinal tumors between 2012 and 2014 had been recognized, with 540 instances utilizing BMP-2 (5.eight%). Primarily based on preoperative prognosis, the speed of BMP-2 use in main benign tumor surgical procedure was four.9%, 7.6% for main malignant tumors, and 5.7% for metastatic lesions (p-value zero.607). The general complication price was 13.2% (13.four% within the NO-BMP-2 group vs. 11.1% within the BMP-2 group (p=zero.504). Sufferers who acquired this development issue had been much less prone to have epidural spinal wire compression at presentation (37.zero% vs. 49.2%, p=zero.014), and extra prone to have elective surgical procedure (53.7% vs. 37.7%, p<zero.001). Primarily based on hospital location, the very best utilization of BMP-2 was within the South (7.four% price, p=zero.002). There was no statistical distinction between age, intercourse, insurance coverage standing, co-morbidities, the presence of a pathological fracture, or the usage of inpatient radio/chemotherapy between sufferers who acquired BMP-2 and controls.
CONCLUSION: BMP-2 has been used off-label to advertise arthrodesis; nevertheless, its use on sufferers with spinal tumors is controversial. On this nationwide research, BMP-2 use was highest within the South, in sufferers with out epidural wire compression at presentation, and in elective instances.
PMID: 29733987 [PubMed – as supplied by publisher]