Bone Morphogenetic Proteins in Lumbar Arthrodesis: What Is All the Debate About? Commentary on an article by Daniel C. Beachler, PhD, MHS, et al.: "Bone Morphogenetic Protein Use and Cancer Risk Among Patients Undergoing Lumbar Arthrodesis: A Case-Cohort Study Using the SEER-Medicare Database".

Abstract

Controversy continues surrounding the use of recombinant human bone morphogenetic proteins (rhBMPs) in spine surgical procedures. At the present time, >20 BMPs have been discovered. Of these, the U.S. Food and Drug Administration (FDA) has only approved the use of one for lumbar arthrodesis: rhBMP-2. Since its approval in 2002, the use of rhBMP-2 in lumbar spine surgical procedures has varied, oscillating in response to FDA Public Health Notifications and professional society recommendations1. Prior to the 2008 FDA Public Health Notification concerning the safety of BMPs in cervical surgical procedures2, >50% of anterior lumbar interbody fusion procedures, 43% of posterior lumbar interbody fusion or transforaminal lumbar interbody fusion procedures, and 30% of posterior lumbar fusion procedures utilized BMPs. In 2010, their use peaked, with 45.2% of lumbar arthrodeses using rhBMP-21. Following the 2008 FDA notification, the mean rate of BMP use in lumbar arthrodesis decreased steadily at 0.978% per month until the end of 20121. In their article, Beachler et …