SynthesisSpine2020
Comparative Clinical Effectiveness and Safety of Bone Morphogenetic Protein Versus Autologous Iliac Crest Bone Graft in Lumbar Fusion: A Meta-analysis and Systematic Review.
Synthesis in Spine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 30 citations in OpenAlex.
- Primary bone augmentation leads to equally stable marginal tissue conditions comparing the use of xenograft blocks infused with BMP-2 and autogenous bone blocks: A 3D analysis after 3 years.Clinical oral implants research · 2021Trial
- Resurgence in BMP Use in Spine Surgery: An Analysis From 2010 to 2022.Global spine journal · 2026Article
- Efficacy of low-dose Escherichia coli-derived recombinant human bone morphogenetic protein-2 in minimally invasive transforaminal lumbar interbody fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Global evolution of robot-assisted spine surgery: a bibliometric and knowledge-mapping study (1997-2026).Journal of robotic surgery · 2026Article
- Outcomes comparison between novel hydroxyapatite enhanced polyetheretherketone and titanium implants after anterior lumbar interbody fusion.Journal of spine surgery (Hong Kong) · 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
- Bone Morphogenetic Proteins in Orthopedics: A Bibliometric Analysis.Indian journal of orthopaedics · 2025Article
- Transforming spinal surgery with innovations in biologics and additive manufacturing.Materials today. Bio · 2025Review
- Lateral Lumbar Interbody Fusion With rhBMP-2 can Achieve High Fusion Rates in Adult Spine Deformity Surgeries.Global spine journal · 2024Article
- Application ofBioengineering (Basel, Switzerland) · 2023Article
- Efficacy and Safety of Beta-Tricalcium Phosphate/Polylactic-Co-Glycolic Acid for Implantation of Bone Defects.Cureus · 2023Article
- Postoperative Lumbar Fusion Bone Morphogenic Protein-Related Epidural Cyst Formation.AJNR. American journal of neuroradiology · 2023Article
- Outcome of Ti/PEEK Versus PEEK Cages in Minimally Invasive Transforaminal Lumbar Interbody Fusion.Global spine journal · 2023Article
- Experience With Recombinant Human Bone Morphogenetic Protein-2 in Posterior Lumbar Interbody Fusion: A Retrospective Review of 1019 Procedures.International journal of spine surgery · 2023Article
- Article
- Novel Surgical Technique for Adolescent Idiopathic Scoliosis: Minimally Invasive Scoliosis Surgery.Journal of clinical medicine · 2022Review
- Evaluation of the efficacy and safety of Escherichia coli-derived recombinant human bone morphogenetic protein-2 in transforaminal lumbar interbody fusion to treat degenerative spinal disease: a protocol of prospective, randomized controlled, assessor-blinded, open-label, multicenter trial.Journal of orthopaedic surgery and research · 2022Article
- Commercial Bone Grafts Claimed as an Alternative to Autografts: Current Trends for Clinical Applications in Orthopaedics.Materials (Basel, Switzerland) · 2021Review
- Influence of the TGF-β Superfamily on Osteoclasts/Osteoblasts Balance in Physiological and Pathological Bone Conditions.International journal of molecular sciences · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designThis is a systematic literature review and meta-analysis.
objectiveWe aimed to evaluate the efficacy and safety of recombinant human bone morphogenetic protein (RhBMP) and autologous iliac crest bone graft (ICBG) in lumbar fusion. SUMMARY OF BACKGROUND DATA: RhBMP has been emphasized in lumbar fusion due to high fusion success rate. However, ICBG remains the criterion standard graft approach for lumbar fusion. The safety and effectiveness of rhBMP are controversial.
methodsProspective randomized controlled trials were searched from PubMed, EMBASE, and Cochrane Central Register of Controlled Trails by using Medical Subject Headings terms "bone morphogenetic protein,' "bone transplantation,' and "spinal fusion.' Two independent investigators screened eligible studies, assessed the bias of original articles, extracted data including fusion success, Oswestry disability index improvement, improved short form 36 questionnaire scores, adverse events and re-operation, and a subgroup analysis. The GRADE approach was used to grade quality of evidence.
resultsTwenty randomized controlled trials (2185 patients) met the inclusion criteria. There were higher fusion success rate (odds ratio [OR] 3.79, 95% confidence interval [CI] 1.88-7.63, P = 0.0002), better improvement of Oswestry Disability Index (mean difference 1.54, 95% CI 0.18-2.89, P = 0.03), and lower re-operation rate (OR 0.59, 95% CI 0.43-0.80, P = 0.0007) in rhBMP group. Heterogeneity was obvious in fusion success rate (I = 58%); hence, a subgroup analysis, based on protein type (rhBMP-2 or rhBMP-7), was performed, which suggested that only rhBMP-2 was better than ICBG for lumbar fusion. There was no difference in the incidence of adverse events between rhBMP and ICBG (OR 0.91, 95% CI 0.70-1.18, P = 0.47).
conclusionIn lumbar fusion, rhBMP-2 exhibited a higher fusion success rate and reduced the risk of re-operation. No difference in complication rate is between rhBMP (rhBMP-2 and rhBMP-7) and ICBG. We suggest rhBMP especially rhBMP-2 as an effective substitute for ICBG for lumbar fusion. LEVEL OF EVIDENCE: 1.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.