Patient outcomes with bone morphogenetic protein (BMP) or autologous bone grafts in posterior lumbar fusion.

Abstract

INTRODUCTION/BACKGROUND: Autologous bone (AB) and Bone Morphogenetic Protein (BMP) can be used independently or in combination to promote bony fusion after lumbar spine surgery. However, there is ongoing uncertainty about the clinical benefit of BMP. METHOD: Clinical data was collected on 141 patients who underwent minimally invasive posterior lumbar surgery from 2008 to 2012 by a single surgeon (PD) at a single centre (Epworth HealthCare, Richmond). Patients completed questionnaires pre-surgery, and at six weeks, six months, 12 months, and 24 months post surgery. The validated outcome measures were the Oswestry Disability Index (ODI) and the visual analogue scale (VAS) for leg and back pain. CT was used to assess bony fusion by a single radiologist (CB) with a report of solid or not solid. Patients were grouped by the type of bone graft: autologous, BMP-2, and BMP-7. RESULTS: results demonstrated that solid fusion is more likely to be achieved with BMP-2 or BMP-7 rather than AB (p=0.02). However, there was no statistically significant difference between the AB and BMP groups regarding the clinical outcome. CONCLUSION: Our experience demonstrates that although patients achieved better fusion rates in the BMP groups, it did not correlate with a better clinical outcome.