A meta-analysis on efficacy and complications of bone morphogenetic protein-2 for the posterior fusion of the cervical spine
Abstract
OBJECTIVE
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is effective for promoting robust fusion for long-level cervical deformity and revision surgeries. However, only few studies have reported its efficacy and complications in posterior cervical fusion (PCF).
METHODS
Therefore, we evaluated the efficacy and complications of rhBMP-2 application in PCF surgery by searching three electronic databases (PubMed, Cochrane Database, and EMBASE) for studies that evaluated the use of rhBMP-2 in PCF. Five studies (one prospective and four retrospective) were included in the meta-analysis.
RESULTS
The quality of each study was assessed, and data on pseudarthrosis, wound infection, neurologic, and immediate medical complications were extracted and analyzed. We found that the use of rhBMP-2 in PCF showed significant benefits in terms of pseudarthrosis and no significant increases in the risk for neurologic and immediate medical complications regardless of the dose. However, high-dose (> 2.1 mg/level) rhBMP-2 was a risk factor for wound infection after PCF.
CONCLUSIONS
Our meta-analysis of the currently available literature suggests that patients with PCF may benefit from BMP-2 usage without increasing the risk of complications. However, dose control and con-tainment are important to ensure a low risk of complications.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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