Bone Morphogenetic Protein in Spine Surgery: Current and Future Uses

Even, Jesse L.; Eskander, Mark S.; Kang, James D.

doi:10.5435/00124635-201209000-00001

Cited by 72 publications

(46 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The concerns put forward by authors like Dimar and Carragee have led others to avoid rhBMP-2 in patients with a history of cancer [35]. However, in our opinion the lack of strong evidence that correlates rhBMP-2 and cancer does not support denying rhBMP-2 to patients with a cancer history who may benefit from it.…”

Section: Discussioncontrasting

confidence: 41%

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Siemionow

Sundberg

Tyrakowski³

et al. 2014

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Bone morphogenetic proteins (BMPs) have been utilized in spine surgery for over 10 years as a bone graft substitute. Potential BMP-related adverse effects including retrograde ejaculation and heterotopic neuroforaminal bone formation have been described. Additionally, some studies have suggested an association between BMP and cancer. Inconsistencies exist in the published spine literature with regards to the incidence and association of complications with BMP utilization. In a point-counterpoint format, this article discusses the current evidence concerning the relationship between the utilization of BMP in spinal fusion and the risk of cancer, retrograde ejaculation (RE), neuroforaminal bone formation, and its role in anterior cervical spine surgery and adolescents.Keywords Bone morphogenetic protein . Retrograde ejaculation . Anterior cervical fusion . Neuroforaminal bone growth . Cancer Point-counterpointRetrograde Ejaculation (RE) RE occurs secondary to impaired function of the internal vesicle sphincter muscle. Anterior lumbar approaches, particularly at the L5-S1 level, carry a greater potential for damage to the superior hypogastric sympathetic plexus, which innervates the internal vesicle sphincter muscle. Other etiologies of RE including diabetes, benign prostate hypertrophy and its treatment, multiple sclerosis, pelvic trauma, and pelvic or rectal surgery [1][2][3][4][5][6]. RE following anterior lumbar spine surgery is also purported to be related to the surgical approach [7][8][9].Burkus et al first published a prospective, randomized, nonblinded FDA-approved study concerning the use of rhBMP-2 in ALIF [8]. Six males (4.1 %; 6/146) reported RE following surgery, of which 4 underwent a transperitoneal approach (TPA) (13.3 %; 4 of all 30 males that underwent TPA) and 2 underwent a retroperitoneal approach (RPA) (1.8 %; 2 of 116 males that underwent RPA). Since the difference in RE between the TPA and RPA groups was statistically significant the authors concluded that a TPA was associated with a higher risk of RE. No comparison in RE between the investigational and control group was performed. The reported differences between the 2 approaches persisted at the 2-year follow-up period [10]. However, in 2010 Smoljanovic et al reviewed the data by Burkus et al [11] and reported that all 6 patients with RE had received rhBMP-2. Thus, the prevalence of RE in the investigational group (rhBMP-2) would have been 7.7 % (6/78 males), which was significantly greater than the control group (ICBG). The reason for ignoring the relationship between RE and rhBMP-2 was questioned, which sparked an intense debate over the potential association between the utilization of rhBMP-2 and RE.Correlation between rhBMP-2 utilization and RE Curr Rev Musculoskelet Med (2014) 7:200-207 DOI 10.1007/s12178-014-9219-x patients (7.2 %) in the rhBMP-2 group developed RE while only 1 of 174 patients (0.6 %; 1/69) reported RE in the control group. Significant differences in RE were also evident among patients that underwent a singl...

show abstract

Section: Discussioncontrasting

confidence: 41%

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Siemionow

Sundberg

Tyrakowski³

et al. 2014

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

“…17,18 Specifically, BMP-2, -4, -6, -7, -9 and -14 have been shown to have significant osteogenic properties. 19,20 BMP-2 and -7, additionally, have been demonstrated to directly promote local neovascularization. 7 Several unique properties of BMP-2 may account for its robust healing potential.…”

Section: Synthetic Bone Graftsmentioning

confidence: 99%

Bone grafts, bone substitutes and orthobiologics

Roberts¹,

2012

View full text Add to dashboard Cite

“…# -number of publications. BMP-8a) have a known osteochondral function (Even et al, 2012). BMP-2 specifically is a disulfide-linked homodimer with a known role in osteoblast differentiation.…”

Section: Erythropoietin) Fgf (Fibroblast Growth Factor) Ftir (Fourimentioning

confidence: 99%

Tissue engineered bone using select growth factors: A comprehensive review of animal studies and clinical translation studies in man

Gothard¹,

Smith²,

Kanczler³

et al. 2014

eCM

158

125

View full text Add to dashboard Cite

Bone Morphogenetic Protein in Spine Surgery: Current and Future Uses

Cited by 72 publications

References 30 publications

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Point-counter-point debate: the association between recombinant human bone morphogenetic protein utilization and complications in spine surgery

Bone grafts, bone substitutes and orthobiologics

Tissue engineered bone using select growth factors: A comprehensive review of animal studies and clinical translation studies in man

Contact Info

Product

Resources

About