Department of Orthopaedic Surgery, Perelman School of Medicine The Spine Center at Pennsylvania Hospital, Philadelphia, PA.
Department of Orthopaedic Surgery, Columbia University Medical Center, The Spine Hospital at New York-Presbyterian, New York, NY.
Clin Spine Surg. 2022 Jul 1;35(6):264-269. doi: 10.1097/BSD.0000000000001301. Epub 2022 Feb 18.
Retrospective Database Study.
Investigate utilization of bone morphogenetic protein (BMP-2) between 2004 and 2014.
The utilization, particularly off-label utilization, of BMP-2 has been controversial and debated in the literature. Given the concerns regarding cancer and potential complications, the risk benefit profile of BMP must be weighed with each surgical case. The debate regarding the costs and potential side effects of BMP-2 compared with autologous iliac crest bone harvest has continued.
The National Inpatient Sample (NIS) database was queried for the use of BMP-2 (ICD-9-CM 84.52) between 2004 and 2014 across 44 states. The NIS database represents a 20% sample of discharges, weighted to provide national estimates. BMP-2 utilization rates in spine surgery fusion procedures were calculated as a fraction of the total number of thoracic, lumbar, and sacral spinal fusion surgeries performed each year.
Between 2004 and 2014, BMP-2 was utilized in 927,275 spinal fusion surgeries. In 2004, BMP-2 was utilized in 28.3% of all cases (N=48,613). The relative use of BMP-2 in spine fusion surgeries peaked in 2008 at 47.0% (N=112,180). Since then, it has continued to steadily decline with an endpoint of 23.6% of cases in 2014 (N=60,863).
Throughout the United States, the utilization of BMP-2 in thoracolumbar fusion surgeries increased from 28.3% to 47.0% between 2004 and 2008. However, from 2008 to 2014, the utilization of BMP-2 in thoracolumbar spine fusion surgeries decreased significantly from 47.0% to 23.4%. While this study provides information on the utilization of BMP-2 for the entire United States over an 11-year period, further research is needed to the determine the factors affecting these trends.
回顾性数据库研究。
调查 2004 年至 2014 年间骨形态发生蛋白（BMP-2）的使用情况。
BMP-2 的使用，特别是超适应证使用，一直是文献中争议和争论的焦点。鉴于对癌症和潜在并发症的担忧，必须权衡 BMP 的风险效益情况，再考虑每个手术病例。关于 BMP-2 与自体髂嵴骨采集相比的成本和潜在副作用的争论仍在继续。
在 2004 年至 2014 年期间，通过国家住院患者样本（NIS）数据库，对 44 个州的 BMP-2（ICD-9-CM 84.52）的使用情况进行了查询。NIS 数据库代表了 20%的出院患者样本，经过加权处理以提供全国估计数。每年胸椎、腰椎和骶骨脊柱融合手术的总数计算 BMP-2 在脊柱融合手术中的使用率。
2004 年至 2014 年间，BMP-2 用于 927275 例脊柱融合手术。2004 年，BMP-2 用于所有病例的 28.3%（N=48613）。BMP-2 在脊柱融合手术中的相对使用在 2008 年达到 47.0%的峰值（N=112180）。此后，其使用率持续稳步下降，2014 年达到 23.6%的终点（N=60863）。
在美国，胸腰椎融合手术中 BMP-2 的使用率从 2004 年的 28.3%增加到 2008 年的 47.0%。然而，从 2008 年到 2014 年，胸腰椎脊柱融合手术中 BMP-2 的使用率从 47.0%显著下降到 23.4%。虽然这项研究提供了 11 年来美国全国范围内 BMP-2 使用情况的信息，但仍需要进一步研究以确定影响这些趋势的因素。
