Trends Analysis of rhBMP2 Utilization in Single-Level Anterior Lumbar Interbody Fusion in the United States

Abstract

Study Design:Retrospective case study.Objective:To evaluate the trends and demographics of recombinant human bone morphogenetic protein 2 (rhBMP2) utilization in single-level anterior lumbar interbody fusion (ALIF) in the United States.Methods:Patients who underwent single-level ALIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were analyzed for each patient.Results:A total of 921 patients were identified who underwent a single-level ALIF in this study. The average rate of single-level ALIF with rhBMP2 utilization increased (35%-48%) from 2005 to 2009, but sharply decreased to 16.7% in 2010 and 15.0% in 2011. The overall incidence of single-level ALIF without rhBMP2 (0.20 cases per 100 000 patients) was more than twice of the incidence of single-level ALIF with rhBMP2 (0.09 cases per 100 000 patients). The average rate of single-level ALIF with rhBMP2 utilization is highest in West (41.4%), followed by Midwest (33.3%), South (26.5%) and Northeast (22.2%). The highest incidence of single-level ALIF with rhBMP2 was observed in the group aged less than 65 years (compared with any other age groups, P < .001), with an incidence of 0.21 per 100 000 patients.Conclusions:The incidence of rhBMP2 utilization in single-level ALIF increased from 2006 to 2009, but decreased in 2010 and 2011. The Northeast region had the lowest incidence of rhBMP2 utilization. The group aged less than 65 years trended to have the higher incidence of single-level ALIF with rhBMP2 utilization.

Safety and efficacy of a new moldable and compression resistant matrix carrier with recombinant human bone morphogenetic protein-2 in the rabbit bone defect model

“…In 2002, the FDA approved the use of recombinant human bone morphogenetic protein-2 (rhBMP-2); since then, it has been widely used for spinal fusion (23,37). Although rhBMP-2 is highly efficient in improving osteoblast formation and activating osteogenesis and bone healing, it has some adverse effects, such as heterotopic ossification near critical vital structures, diffusion to the surrounding areas, and osteoclastic reaction due to rapid release of rhBMP-2 that causes bone resorption (21,29,34,39,41).…”

AOSpine Knowledge Forums: Research in Motion

“…With the aforementioned framework in place, since 2011 the AOSpine Knowledge Forums have published over 139 peer-reviewed articles in numerous esteemed journals such as Cancer , 1 Neuro-Oncology , 2 Journal of Bone and Joint Surgery , 3 Spine , 4,5 European Spine Journal , 6 and the Global Spine Journal , 7-10 among others. The AOSpine Knowledge Forums have amassed over 20 international awards and accolades related to their research, such as the Russel A. Hibbs Award, the Whitecloud Award, various Young Investigator Awards, and other Best Clinical Presentation Awards at various conferences.…”

“…Through this research and collaboration, the Forums have gone on to develop guidelines for the diagnosis and treatment of various spinal disorders, outcome instruments, cost-analyses/cost-effectiveness, novel classification schemes, predictive modelling, and treatment recommendations. 2-25 As a knowledge “mobilizer,”they have sought to raise awareness of their findings via knowledge exchange and dissemination, have fostered research education and mentorship, and strived to translate their findings to ultimately improve patient care and quality of life on the international stage.…”