Alobaidaan Raed, Cohen Jeremiah R, Lord Elizabeth L, Buser Zorica, Yoon S Tim, Youssef Jim A, Park Jong-Beom, Brodke Darrel S, Wang Jeffrey C, Meisel Hans-Joerg
Ministry of Health, Riyadh, Saudi Arabia.
University of California, Los Angeles, CA, USA.
Global Spine J. 2017 Dec;7(8):770-773. doi: 10.1177/2192568217696695. Epub 2017 May 16.
Retrospective cohort study among Medicare beneficiaries who underwent posterior lumbar interbody fusion (PLIF) surgery.
To identify the complication rates associated with the use of bone morphogenetic protein 2 (BMP2) in PLIF. Human BMP2 is commonly used in the "off-label" manner for various types of spine fusion procedures, including PLIF. However, recent studies have reported potential complications associated with the recombinant human BMP2 (rhBMP2) use in the posterior approach.
Medicare records within the PearlDiver database were queried for patients undergoing PLIF procedure with and without rhBMP2 between 2005 and 2010. We evaluated complications within 1 year postoperatively. Chi-square was used to compare the complication rates between the 2 groups.
A total of 8609 patients underwent PLIF procedure with or without rhBMP2. Individual complication rates in the rhBMP2 group ranged from 0.45% to 7.68% compared with 0.65% to 10.99 in the non-rhBMP2 group. Complication rates for cardiac, pulmonary, lumbosacral neuritis, infection, wound, and urinary tract (include acute kidney failure and post-operative complications) were significantly lower in the rhBMP2 group ( < .05). There was no difference in the rates of central nervous system complications or radiculitis between the 2 groups.
Our data showed that the patients who received rhBMP2 had lower complication rates compared to the non-rhBMP2 group. However, use of rhBMP2 was associated with a higher rate of pseudarthrosis. We did not observe any difference in radiculitis and central nervous system complications between the groups.
对接受后路腰椎椎间融合术（PLIF）的医疗保险受益人进行回顾性队列研究。
确定在PLIF中使用骨形态发生蛋白2（BMP2）相关的并发症发生率。人BMP2通常以“未标靶”方式用于包括PLIF在内的各种脊柱融合手术。然而，最近的研究报道了在后路手术中使用重组人BMP2（rhBMP2）存在潜在并发症。
查询PearlDiver数据库中2005年至2010年间接受有或无rhBMP2的PLIF手术患者的医疗保险记录。我们评估术后1年内的并发症情况。采用卡方检验比较两组的并发症发生率。
共有8609例患者接受了有或无rhBMP2的PLIF手术。rhBMP2组的个体并发症发生率在0.45%至7.68%之间，而非rhBMP2组为0.65%至10.99%。rhBMP2组中心脏、肺部、腰骶神经炎、感染、伤口及泌尿系统（包括急性肾衰竭和术后并发症）的并发症发生率显著更低（P<0.05）。两组中枢神经系统并发症或神经根炎的发生率无差异。
我们的数据显示，与未使用rhBMP2的组相比，接受rhBMP2治疗的患者并发症发生率更低。然而，使用rhBMP2与假关节形成率较高有关。我们未观察到两组在神经根炎和中枢神经系统并发症方面存在任何差异。
