Assessment of outcome following the use of recombinant human bone morphogenetic protein-2 for spinal fusion in the elderly population
Title
Assessment of outcome following the use of recombinant human bone morphogenetic protein-2 for spinal fusion in the elderly population
Creator
Shweikeh F; Hanna G; Bloom L; Sayegh E T; Liu J; Acosta F L; Drazin D
Publisher
Journal of Neurosurgical Sciences
Date
2016
2016-06
Description
INTRODUCTION: Although the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for spinal fusion has been fairly studied in the general population, relatively little research has been conducted on its use in the elderly patient demographic despite this population's growth. The authors sought to examine the clinical efficacy, complication rate, and cost-effectiveness of rhBMP-2 use in elderly patients undergoing spinal fusion surgery. EVIDENCE ACQUISITION: We conducted a systematic review of the published literature for elderly patients that underwent spinal fusion surgery with the use of rhBMP-2. A systematic search was performed utilizing the PUBMED and MEDLINE databases in order to identify all papers dealing with recombinant human Bone Morphogenic Protein-2 use in patients over the age of 60 years. EVIDENCE SYNTHESIS: Twenty-five papers were identified that met our inclusion criteria. While successful fusion, improvement in pain, and improved quality of life were encountered in elderly patients who were treated with fusions surgery along with rhBMP-2, there were several complications that were encountered including seroma formation, pleural effusions, and bone non-union. CONCLUSIONS: The literature demonstrated that BMP serves as a potent osteoinductive agent in the elderly with similar efficacy to bone auto graft. Although use of BMP showed mixed results and had higher initial costs, when taken into account with complication correction and costs, BMP usage appears to be more economically beneficial overall. Future studies are needed to clarify the clinical significance of the complications encountered in elderly patients treated with rhBMP-2. Future research can assist in developing recommendations which can minimize these risks in the elderly patient demographic.
Subject
Allografts; anterior cervical-spine; Bone morphogenetic protein-2; clinical article; ectopic bone; Elderly; graft; lumbar interbody fusion; Neurosciences & Neurology; off-label use; older-adults; Outcome Assessment (Health Care); perioperative complications; rhBMP-2; rhBMP-2; Spinal fusion; Spine surgery; Surgery; Surgery
Identifier
n/a
Format
Journal Article
URL Address
n/a
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Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
256-271
Issue
2
Volume
60
Citation
Shweikeh F; Hanna G; Bloom L; Sayegh E T; Liu J; Acosta F L; Drazin D, “Assessment of outcome following the use of recombinant human bone morphogenetic protein-2 for spinal fusion in the elderly population,” NEOMED Bibliography Database, accessed October 2, 2023, https://neomed.omeka.net/items/show/8041.