Abstract
Study Design: Retrospective study. Objectives: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used in spinal fusion surgery, but there is little information on rhBMP-2 utilization in single-level posterior lumbar interbody fusion (PLIF). The purpose of our study was to evaluate the trends and demographics of rhBMP-2 utilization in single-level PLIF. Methods: Patients who underwent single-level PLIF from 2005 to 2011 were identified by searching ICD-9 diagnosis and procedure codes in the PearlDiver Patient Records Database, a national database of orthopedic insurance records. The year of procedure, age, gender, and region of the United States were recorded for each patient. Results were reported for each variable as the incidence of procedures identified per 100 000 patients searched in the database. Results: A total of 2735 patients had single-level PLIF. The average rate of single-level PLIF with rhBMP-2 maintained at a relatively stable level (28% to 31%) from 2005 to 2009, but decreased in 2010 (9.9%) and 2011 (11.8%). The overall incidence of single-level PLIF without rhBMP-2 (0.68 cases per 100 000 patients) was statistically higher (P <.01) compared to single-level PLIF with rhBMP-2 (0.21 cases per 100 000 patients). The average rate of single-level PLIF with rhBMP-2 utilization was the highest in West (30.1%), followed by Midwest (26.9%), South (20.5%), and Northeast (17.8%). The highest incidence of single-level PLIF with rhBMP-2 was observed in the age group <65 years (0.3 per 100 000 patients). Conclusions: To our knowledge, this is the first study to report on the demographics associated with rhBMP-2 use in single-level PLIF. There was a 3-fold increase in the rate of PLIF without rhBMP-2 compared to PLIF with rhBMP-2, with both procedures being mainly done in patients less than 65 years of age.
Original language | English |
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Pages (from-to) | 624-628 |
Number of pages | 5 |
Journal | Global Spine Journal |
Volume | 7 |
Issue number | 7 |
DOIs | |
State | Published - 1 Oct 2017 |
Bibliographical note
Funding Information:The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: ZB—Xenco Medical (consultancy), AO Spine (consultancy, past). HJM—Dr Meisel is consultant (money paid to institution) – Regenerate Life Sciences GmbH for DiFusion (ongoing), Co.don (past); royalties from: Medtronic, Fehling Aesculap (past); stocks (money paid to institution) - Regenerate Life Sciences GmbH in DiFusion. STY— Dr Yoon owns stock in Phygen, Alphatec; Meditech, royalties Meditech Advisors, Stryker Spine (Paid directly to institution/ employer), grant from AOSpine (Paid directly to institution/ employer), research support from Biomet (Research support given to AREF), nonfinancial research support from Nuvasive and Medtro-nic. JAY—Royalties: NuVasive, Osprey Medical, Amedica, Integra; Stock Ownership: Benvenue Medical, Paradigm Spine, Promethean Surgical Devices, Spinal Ventures, VertiFlex, Spinicity, ISD, Providence Medical; Private Investments: Amedica, VertiFlex, Benvenue, NuVasive; Consulting: Integra, NuVasive, Amedica, HealthTrust; Board of Directors: Durango Orthopedic Associates (None); Research Support (Staff and/or Materials): Globus Medical (Paid directly to institution/employer), NuVasive (Paid directly to institution/ employer), VertiFlex (Paid directly to institution/employer), Integra (Paid directly to institution/employer). DB—Consultant – Vallum, Royalties – America, DePuy Synthes, Medtronic, Fellowship Support – AOSpine (paid directly to institution). JCW—Royalties: Aesculap, Biomet, Amedica, Seaspine , Synthes ; Stock Ownership: Fziomed; Private Investments: Promethean Spine, Paradigm spine, Benevenue, NexGen, Vertiflex, electrocore, surgitech, expanding orthopaedics, osprey, bone biologics, curative biosciences, pearldiver; Board of Directors: North American Spine Society (non-financial, reimbursement for travel for board meetings, courses, etc.), North American Spine Foundation (non-financial), Cervical Spine Research Society (non-financial, reimbursement for travel for board meetings), AO Spine/AO Foundation (honorariums for board position); Fellowship Support: AO Foundation (spine fellowship funding paid to institution).
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by AOSpine and departmental funds. AOSpine is a clinical division of the AO Foundation—an independent medically guided nonprofit organization. The AOSpine Knowledge Forums are pathology focused working groups acting on behalf of AOSpine in their domain of scientific expertise. Each forum consists of a steering committee of up to 10 international spine experts who meet on a regular basis to discuss research, assess the best evidence for current practices, and formulate clinical trials to advance spine care worldwide. Study support is provided directly through AOSpine’s Research Department.
Publisher Copyright:
© 2017, © The Author(s) 2017.
Keywords
- age
- demographics
- gender
- PLIF
- posterior lumbar interbody fusion
- recombinant human bone morphogenetic protein-2
- rhBMP-2
- single-level