ArticleThe spine journal : official journal of the North American Spine Society2015
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
Article in The spine journal : official journal of the North American Spine Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Resurgence in BMP Use in Spine Surgery: An Analysis From 2010 to 2022.Global spine journal · 2026Article
- Is Bone Morphogenetic Protein the new Gold Standard? A Meta-Analysis and Systematic Review of Bone Morphogenetic Protein vs Autologous Iliac Crest Bone Graft Use in Spinal Fusion.Orthopedic reviews · 2026Article
- Current Trends in Recombinant Human Bone Morphogenetic Protein 2 (rhBMP2) Usage for Spinal Fusion Surgery.Medicina (Kaunas, Lithuania) · 2023Article
- Current and Future Concepts for the Treatment of Impaired Fracture Healing.International journal of molecular sciences · 2019Review
- Lattice Microarchitecture for Bone Tissue Engineering from Calcium Phosphate Compared to Titanium.Tissue engineering. Part A · 2018Article
- The Biological Enhancement of Spinal Fusion for Spinal Degenerative Disease.International journal of molecular sciences · 2018Review
- Trends in the Use of Bone Morphogenetic Protein-2 in Adult Spinal Deformity Surgery: A 10-Year Analysis of 54 054 Patients.International journal of spine surgery · 2018Article
- Osteoconductive Microarchitecture of Bone Substitutes for Bone Regeneration Revisited.Frontiers in physiology · 2018Article
- Letter: Reconsidering Bone Morphogenetic Protein in the Cervical Spine: Selective Use for Managing Type II Odontoid Fractures in the Elderly.Operative neurosurgery (Hagerstown, Md.) · 2017Article
- Biologic enhancement of spinal fusion with bone morphogenetic proteins: current position based on clinical evidence and future perspective.Journal of spine surgery (Hong Kong) · 2016Article
- Bone Morphogenetic Protein Use and Cancer Risk Among Patients Undergoing Lumbar Arthrodesis: A Case-Cohort Study Using the SEER-Medicare Database.The Journal of bone and joint surgery. American volume · 2016Article
- LIPUS promotes spinal fusion coupling proliferation of type H microvessels in bone.Scientific reports · 2016Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
background contextUse of bone morphogenetic protein (BMP) as an adjunct to spinal fusion surgery proliferated after Food and Drug Administration (FDA) approval in 2002. Major safety concerns emerged in 2008. PURPOSE: The purpose of this study was to examine whether published concerns about the safety of BMP altered clinical practice. STUDY DESIGN/
settingThe study design involved the analysis of the National Inpatient Sample from 2002 through 2012. PATIENT SAMPLE: Adults (older than 20 years) undergoing an elective fusion operation for common degenerative diagnoses were identified using codes from the International Classification of Diseases, ninth revision, Clinical Modification. OUTCOME MEASURES: Outcome measures were proportion of cervical and lumbar fusion operations, over time, that involved BMP.
methodsWe aggregated the data into a monthly time series and reported the proportion of cervical and lumbar fusion operations, over time, that involved BMP. Autoregressive Integrated Moving Average, a regression model for time series data, was used to test whether there was a statistically significant change in the overall rate of BMP use after an FDA Public Health Notification in 2008.
resultsUse of BMP in spinal fusion procedures increased rapidly until 2008, involving up to 45.2% of lumbar and 13.5% of cervical fusions. Bone morphogenetic protein use significantly decreased after the 2008 FDA Public Health Notification and revelations of financial payments to surgeons involved in the pivotal FDA-approved trials. For lumbar fusion, the average annual increase was 7.9 percentage points per year from 2002 to 2008, followed by an average annual decrease of 11.7 percentage points thereafter (p≤.001). Use of BMP in cervical fusion increased 2.0% per year until the FDA Public Health Notification, followed by a 2.8% per year decrease (p=.035).
conclusionsUse of BMP in spinal fusion surgery declined subsequent to published safety concerns and revelations of financial conflicts of interest for investigators involved in the pivotal clinical trials.
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