Quantitative Assessment of Retrograde Ejaculation Using Semen Analysis, Comparison to a Standardized Qualitative Questionnaire and Investigating the Impact of rhBMP-2

Tepper, Gil; Rabbani, Ramin; Yousefzadeh, Michelle; Prince, D. R.

doi:10.1016/j.spinee.2012.08.251

Cited by 5 publications

(8 citation statements)

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“…Retrograde ejaculation is typically assessed via questionnaires; only 1 study group performed a quantitative analysis of retrograde ejaculation. 83 More than half of published reports provided information regarding postoperative endplate resorption and graft subsidence. 5,7,13,16,20,48,55,77 Studies on TLIF reported radiculopathy, ectopic/heterotopic bone formation, seroma, and wound infection.…”

Section: Data Extractionmentioning

confidence: 99%

“…A total of 9 publications reported on the effect of BMP on clinical efficacy and complications following ALIF 5,14,16,20,22,48,55,77,83 (Table 4). Five studies involved prospective cohorts, 14,16,48,77,83 of which 3 contained a control group. 16,77,83 Of 6 included case-control studies, 4 had a low RoB 16,22,77,83 and 2 had a high RoB.…”

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

“…Five studies involved prospective cohorts, 14,16,48,77,83 of which 3 contained a control group. 16,77,83 Of 6 included case-control studies, 4 had a low RoB 16,22,77,83 and 2 had a high RoB. 20,55 All 3 included cases series 5,14,48 were of high quality.…”

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

“…Retrograde ejaculation was assessed in the majority of studies. All but 1 study 83 used questionnaires to inquire about quality of erections, quality of ejaculate, and clarity of postejaculation urine to assess retrograde ejaculation. In a retrospective case series, Carragee and colleagues reported 5 cases of retrograde ejaculation in the BMP group (7.2%) compared with 1 case (0.6%) in the control group.…”

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

“…5,14,16,48,77 As mentioned before, there is only 1 study to date that has used an objective quantitative method for retrograde ejaculation assessment following ALIF. 83 Preoperatively, patients underwent a semen and postejaculatory urine analysis that was repeated 3-6 months after ALIF. Tepper and colleagues determined the diagnosis based on laboratory data in 2 patients who had undergone ALIF with BMP (9.5%) and in 2 patients in the control group (10.0%).…”

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

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Exploratory meta-analysis on dose-related efficacy and morbidity of bone morphogenetic protein in spinal arthrodesis surgery

Hofstetter

Hofer

Levi

2016

SPI

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OBJECT Bone morphogenetic protein (BMP) is frequently used for spinal arthrodesis procedures in an “off-label” fashion. Whereas complications related to BMP usage are well recognized, the role of dosage is less clear. The objective of this meta-analysis was to assess dose-dependent effectiveness (i.e., bone fusion) and morbidity of BMP used in common spinal arthrodesis procedures. A quantitative exploratory meta-analysis was conducted on studies reporting fusion and complication rates following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterolateral lumbar fusion (PLF) supplemented with BMP. METHODS A literature search was performed to identify studies on BMP in spinal fusion procedures reporting fusion and/or complication rates. From the included studies, a database for each spinal fusion procedure, including patient demographic information, dose of BMP per level, and data regarding fusion rate and complication rates, was created. The incidence of fusion and complication rates was calculated and analyzed as a function of BMP dose. The methodological quality of all included studies was assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were analyzed using a random-effects model. Event rates are shown as percentages, with a 95% CI. RESULTS Forty-eight articles met the inclusion criteria: ACDF (n = 7), PCF (n = 6), ALIF (n = 9), TLIF/PLIF (n = 17), and PLF (n = 9), resulting in a total of 5890 patients. In ACDF, the lowest BMP concentration analyzed (0.2–0.6 mg/level) resulted in a fusion rate similar to the highest dose (1.1–2.1 mg/level), while permitting complication rates comparable to ACDF performed without BMP. The addition of BMP to multilevel constructs significantly (p < 0.001) increased the fusion rate (98.4% [CI 95.4%–99.4%]) versus the control group fusion rate (85.8% [CI 77.4%–91.4%]). Studies on PCF were of poor quality and suggest that BMP doses of ≤ 2.1 mg/level resulted in similar fusion rates as higher doses. Use of BMP in ALIF increased fusion rates from 79.1% (CI 57.6%–91.3%) in the control cohort to 96.9% (CI 92.3%–98.8%) in the BMP-treated group (p < 0.01). The rate of complications showed a positive correlation with the BMP dose used. Use of BMP in TLIF had only a minimal impact on fusion rates (95.0% [CI 92.8%–96.5%] vs 93.0% [CI 78.1%–98.0%] in control patients). In PLF, use of ≥ 8.5 mg BMP per level led to a significant increase of fusion rate (95.2%; CI 90.1%–97.8%) compared with the control group (75.3%; CI 64.1%–84.0%, p < 0.001). BMP did not alter the rate of complications when used in PLF. CONCLUSIONS The BMP doses used for various spinal arthrodesis procedures differed greatly between studies. This study provides BMP dosing recommendations for the most common spine procedures.

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Section: Data Extractionmentioning

confidence: 99%

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

Section: Anterior Lumbar Interbody Fusionmentioning

confidence: 99%

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Exploratory meta-analysis on dose-related efficacy and morbidity of bone morphogenetic protein in spinal arthrodesis surgery

Hofstetter

Hofer

Levi

2016

SPI

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Fusion and subsidence rate of stand alone anterior lumbar interbody fusion using PEEK cage with recombinant human bone morphogenetic protein-2

et al. 2013

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A consensus statement regarding the utilization of BMP in spine surgery

Walker

Koerner

Sankarayanaryanan

et al. 2014

Curr Rev Musculoskelet Med

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Recombinant human bone morphogenetic protein - 2 (rh-BMP-2) was first approved by the United States Food and Drug Administration (FDA) in 2002 for use in anterior lumbar interbody fusions. Since that time, it has been estimated that "off label" use accounts for 85 % of applications. Original, industry sponsored studies demonstrated superior fusion rates with decreased incidence of complications when compared with traditional iliac crest bone graft. These studies have been criticized for potential bias and newer research has detailed potential complications as well as alternative applications. Potential off label uses of rhBMP-2 include: anterior lumbar fusions, single level posterior lumbar fusions, multiple level posterior lumbar fusions, posterior cervical fusions, long deformity fusions, in the presence of vertebral osteomyelitis, and in patients with history of malignancy. A review of the literature related to rhBMP-2 was conducted to evaluate its use for the above-mentioned applications with a special focus on fusion rates, observed complications, and clinical or radiographic outcomes.

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Quantitative Assessment of Retrograde Ejaculation Using Semen Analysis, Comparison to a Standardized Qualitative Questionnaire and Investigating the Impact of rhBMP-2

Cited by 5 publications

References 0 publications

Exploratory meta-analysis on dose-related efficacy and morbidity of bone morphogenetic protein in spinal arthrodesis surgery

Exploratory meta-analysis on dose-related efficacy and morbidity of bone morphogenetic protein in spinal arthrodesis surgery

Fusion and subsidence rate of stand alone anterior lumbar interbody fusion using PEEK cage with recombinant human bone morphogenetic protein-2

A consensus statement regarding the utilization of BMP in spine surgery

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