Protein Often Used in Spinal Fusion Surgery Associated With Higher Rate of Cervical Spine Complications, Greater Hospital Charges
Boston, MA – In the U.S. back pain continues to be a leading cause of disability and one of the most common reasons to see a physician for evaluation. Among various treatment options is spinal fusion surgery, which may use a biological agent known as bone-morphogenetic protein (BMP). Researchers at Brigham and Women’s Hospital (BWH) found that BMP is used in 25 percent of spinal fusion surgeries and is associated with a higher rate of complications in certain types of fusions as well as greater hospital charges, compared to fusions that do not use BMP. This research appears in the June 30, 2009 issue of the Journal of the American Medical Association.
Researchers looked at the outcomes of more than 300,000 patients who underwent spinal fusion surgery. “The use of BMP in these surgeries jumped from less than one percent in 2002 to 25 percent in 2006,” said Kevin Cahill, MD PhD, of the Neurosurgery Department at BWH and lead author of the study. “With the use of BMP on the rise, this study illustrates the need to determine the cost-effectiveness of the product in different procedures.”
The researchers found that immediate postoperative, in-hospital rates of complications among patients undergoing spinal fusion by BMP use status were no higher for lumbar, thoracic, or posterior cervical procedures. However, the use of BMP in anterior cervical fusion procedures was associated with a higher rate of complication occurrence, with the primary increases seen in wound-related complications and dysphagia or hoarseness. BMP use was associated with a longer length of stay in the hospital and greater inpatient hospital charges across all categories of fusion, with an 11 to 41 percent increase in total hospital charges.
“This study has highlighted the need to continue to develop refined guidelines for BMP usage and to further study its long-term risks and benefits,” concluded Dr. Cahill. Other investigators on the study include John H. Chi, MD, PhD, Arthur Day, MD, and Elizabeth B. Claus, MD, PhD, all of the Neurosurgery Department at BWH.
This study was funded by the Brain Science Foundation.
Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit www.brighamandwomens.org.
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