title: A meta analysis of lumbar spinal fusion surgery using bone morphogenetic proteins and autologous iliac crest bone graft.
abstract: BACKGROUND
  Bone morphogenetic protein (BMPs) as a substitute for iliac crest bone graft (ICBG) has been increasingly widely used in lumbar fusion. The purpose of this study is to systematically compare the effectiveness and safety of fusion with BMPs for the treatment of lumbar disease.
  
  
  METHODS
  Cochrane review methods were used to analyze all relevant randomized controlled trials (RCTs) published up to nov 2013.
  
  
  RESULTS
  19 RCTs (1,852 patients) met the inclusion criteria. BMPs group significantly increased fusion rate (RR: 1.13; 95% CI 1.05-1.23, P = 0.001), while there was no statistical difference in overall success of clinical outcomes (RR: 1.04; 95% CI 0.95-1.13, P = 0.38) and complications (RR: 0.96; 95% CI 0.85-1.09, p = 0.54). A significant reduction of the reoperation rate was found in BMPs group (RR: 0.57; 95% CI 0.42-0.77, p = 0.0002). Significant difference was found in the operating time (MD-0.32; 95% CI-0.55, -0.08; P = 0.009), but no significant difference was found in the blood loss, the hospital stay, patient satisfaction, and work status.
  
  
  CONCLUSIONS
  Compared with ICBG, BMPs in lumbar fusion can increase the fusion rate, while reduce the reoperation rate and operating time. However, it doesn't increase the complication rate, the amount of blood loss and hospital stay. No significant difference was found in the overall success of clinical outcome of the two groups.
authors.affiliation: Department of Orthopedics, The first Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Haifei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The fourth Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: China Medical University Computer Center, Shenyang, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Orthopedics, The fourth Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The fourth Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Deri
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Orthopedics, The fourth Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Xinmin
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Orthopedics, The fourth Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Jiuli
authors.initials: J
authors.lastname: An
authors.affiliation: Department of Orthopedics, The first Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D017594:Publication Bias; D012086:Reoperation / Q000706:statistics & numerical data; D062707:Return to Work; D013123:Spinal Fusion; D014182:Transplantation, Autologous
chemical_list: D019485:Bone Morphogenetic Proteins