title: Use of Recombinant Human Bone Morphogenetic Protein-2 in the Treatment of Degenerative Spondylolisthesis.
abstract: METHODS
  A questionnaire survey.
  
  
  OBJECTIVE
  To report the current use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in lumbar fusion procedures for the treatment of degenerative spondylolisthesis (DS), and identify associated factors including fusion technique, surgeon location, surgeon specialty, or surgeon practice model.
  
  
  BACKGROUND
  The prevalence of rhBMP-2 use in fusions increased dramatically from 0.7% in 2002 to 24.7% in 2006, however more recent studies have identified significant complications with its use. Furthermore, an independent review of the industry-sponsored trial data has demonstrated no significant difference in fusion rates or clinical results with the use of rhBMP-2 compared with iliac-crest autograft.
  
  
  METHODS
  In July 2014, a survey was sent requesting information on the usage of rhBMP-2 in the treatment of DS. Determinants included the fusion technique, geographic location, specialty, and associated practice models. No funding was received for this work.
  
  
  RESULTS
  Overall, 7.8% +/- 2.0% of surgeons reported using rhBMP-2 when performing an open L4-L5 posterolateral fusion for DS; 6.2% +/- 1.8% reported using rhBMP-2 for an open L4-L5 interbody fusion, and 12.1% +/- 2.5% reported using rhBMP-2 for a L4-L5 minimally invasive (MIS) interbody fusion. The variables that were statistically associated with the use of rhBMP-2 were North America surgeons (P < 0.0001) and the type of procedure (P = 0.0005).
  
  
  CONCLUSIONS
  Compared with historical data, there has been a dramatic decrease in the number of surgeons using rhBMP-2 in lumbar fusion procedures for the treatment of DS. Currently, rhBMP-2 is more commonly used by surgeons in North America and those performing MIS interbody fusions.
  
  
  METHODS
  N/A.
authors.affiliation: *The Rothman Institute, Thomas Jefferson University, Philadelphia, PA †Department of Orthopedic Surgery, Northwestern University, Chicago, IL.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Schroeder
authors.forename: Wellington K
authors.initials: WK
authors.lastname: Hsu
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kepler
authors.forename: Mark F
authors.initials: MF
authors.lastname: Kurd
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: Alpesh A
authors.initials: AA
authors.lastname: Patel
authors.forename: Jason W
authors.initials: JW
authors.lastname: Savage
mesh_terms: D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D000069471:Neurosurgeons; D011994:Recombinant Proteins / Q000627:therapeutic use; D013123:Spinal Fusion / Q000379:methods; D013168:Spondylolisthesis / Q000453:epidemiology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2