ReviewCureus2026
Local Exposure to Recombinant Human Bone Morphogenetic Protein-2 in Spinal Fusion: Limitations of Total Mass and a Proposed Anatomic Treatment Unit Dose Concentration.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is effective for promoting spinal fusion, but local safety is commonly interpreted from total mass in milligrams. This structured narrative review examines the limitations of total mass and a proposed graft-normalized concentration measure that relates rhBMP-2 mass to the complete graft construct within one anatomic treatment unit (ATU). PubMed was searched on June 27, 2026, for records published from June 1, 2016 through June 26, 2026, using ((((rhBMP-2) OR (recombinant human bone morphogenetic protein-2)) AND (spine)) NOT (Maxillofacial)) NOT (Dental). The search returned 253 records. The evidence base was supplemented by backward citation searching and targeted foundational, mechanistic, anatomical, graft-volume, and regulatory sources, together with one post-search source. In interbody fusion, one ATU is one treated motion segment after cage placement. The product loading concentration, such as 1.5 mg/mL for Infuse Bone Graft (Medtronic; Memphis, Tennessee, USA), describes rhBMP-2 on its carrier before implantation. ATU dose concentration is the rhBMP-2 mass per ATU divided by the total graft volume implanted in that ATU. It is a construct-average descriptor, not a measured tissue concentration; realized exposure also depends on retention, release, mixing, spatial distribution, placement, containment, and local tissue anatomy. Across the reviewed evidence, total mass alone did not provide a sufficient general description of local biological and spatial outcomes when graft configuration, delivery, or anatomy changed. Higher nominal-dose comparisons usually changed other exposure variables, whereas equal-mass experiments produced different biological or spatial outcomes when concentration or delivery changed. These findings support reporting the completed graft construct and local anatomical context alongside mass, but they do not establish total graft volume as the biologically correct denominator or validate ATU dose concentration as an independent predictor of clinical adverse events. ATU dose concentration is therefore presented as a proposed complementary exposure descriptor requiring direct patient-level validation.
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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.