P133. Does bone morphogenic protein (BMP) use reduce pseudoarthrosis rates in single-level TLIF surgeries?

Abstract

BACKGROUND CONTEXT Recombinant human bone morphogenetic protein 2 (rhBMP-2) is a popular biologic product used in transforaminal lumbar interbody fusion (TLIF) surgeries to promote fusion and avoid the morbidity associated with iliac crest autograft. However, use of rhBMP-2 and its effect on pseudarthrosis rates in TLIFs remains unknown. PURPOSE To assess the rates of pseudarthrosis in open and MIS TLIF patients, with and without concurrent rhBMP-2 use. STUDY DESIGN/SETTING Retrospective cohort study at a single academic institution. PATIENT SAMPLE Included: 317 single level TLIF patients. Consisting of 157 open TLIF (OTLIF), 115 bilateral Wiltse MIS TLIF (WTLIF), and 45 hybrid midline MIS with percutaneous pedicle or cortical screws (MTLIF). OUTCOME MEASURES Clinical characteristics, perioperative and postoperative outcomes, surgical procedure, rates of pseudarthrosis diagnosis, and revision for pseudarthrosis. METHODS Patients ≥18 years old undergoing 1-level TLIF with minimum 1-year of clinical and radiographic follow up were included. Pseudarthrosis was determined using both radiographic and clinical evaluations. Differences between groups were assessed by ANOVA and chi squared analyses. Demographic and perioperative characteristics were analyzed by multivariate logistic regression. RESULTS The cohort included 317 patients (mean age 59.68±13.29, F 52.7%). There was no significant difference in gender, BMI, or smoking status among groups (all p>.05). WTLIF had the lowest EBL (ml) (192.16±177.11mL vs 302.73±246.51 vs 363.85±370.49, respectively p= CONCLUSIONS MP use did not reduce the rate of pseudarthrosis or the number of reoperations for pseudarthrosis in this cohort. No difference in pseudarthrosis rates between the three TLIF approaches was noted. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.