title: Analysis of Recombinant Human Bone Morphogenetic Protein-2 Use in the Treatment of Lumbar Degenerative Spondylolisthesis.
abstract: Study DesignRetrospective database review.ObjectiveTo identify trends of the recombinant human bone morphogenetic protein-2 (rhBMP-2) use in the treatment of lumbar degenerative spondylolisthesis (LDS).MethodsPearlDiver Patient Record Database was used to identify patients who underwent lumbar fusion for LDS between 2005 and 2011. The distribution of bone morphogenetic protein use rate (BR) in various surgical procedures was recorded. Patient numbers, reoperation numbers, BR, and per year BR (PYBR) were stratified by geographic region, gender, and age.ResultsThere were 11,335 fusion surgeries, with 3,461 cases using rhBMP-2. Even though PYRB increased between 2005 and 2008, there was a significant decrease in 2010 for each procedure: 404 (34.5%) for posterior interbody fusion, 1,282 (34.3%) for posterolateral plus posterior interbody fusion (PLPIF), 1,477 (29.2%) for posterolateral fusion, and 335 (22.4%) for anterior lumbar interbody fusion. In patients using rhBMP-2, the reoperation rate was significantly lower than in patients not using rhBMP-2 (0.69% versus 1.07%,p< 0.0001). Male patients had higher PYBR compared with female patients in 2008 and 2009 (p< 0.05). The West region and PLPIF had the highest BR and PYBR.ConclusionsOur data shows that the revision rates were significantly lower in patients treated with rhBMP-2 compared with patients not treated with rhBMP-2. Furthermore, rhBMP-2 use in LDS varied by year, region, gender, and type of fusion technique. In the West region, the posterior approach and patients 65 to 69 years of age had the highest rate of rhBMP-2 use.
authors.affiliation: Department of Orthopaedic Surgery, University of California, Los Angeles, California, United States; Department of Orthopaedic Surgery, Nanjing Medical University, Nanjing Hospital, Nanjing, China.
authors.forename: Qingqiang
authors.initials: Q
authors.lastname: Yao
authors.affiliation: Department of Orthopaedic Surgery, University of California, Los Angeles, California, United States.
authors.forename: Jeremiah R
authors.initials: JR
authors.lastname: Cohen
authors.affiliation: Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Buser
authors.affiliation: Department of Orthopaedic Surgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea School of Medicine, Uijongbu, Korea.
authors.forename: Jong-Beom
authors.initials: JB
authors.lastname: Park
authors.affiliation: Department of Orthopedics, University of Utah School of Medicine, Salt Lake City, Utah, United States.
authors.forename: Darrel S
authors.initials: DS
authors.lastname: Brodke
authors.affiliation: Department of Neurosurgery, Bergmannstrost Hospital, Halle, Germany.
authors.forename: Hans-Joerg
authors.initials: HJ
authors.lastname: Meisel
authors.affiliation: Durango Orthopedic Associates, P.C./Spine Colorado, Durango, Colorado, United States.
authors.forename: Jim A
authors.initials: JA
authors.lastname: Youssef
authors.affiliation: Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Emory Spine Center, Atlanta, Georgia.
authors.forename: S Tim
authors.initials: ST
authors.lastname: Yoon
keywords: ALIF; PearlDiver patient record database; demographics; fusion; lumbar degenerative spondylolisthesis; posterolateral; rhBMP-2