Agent to surgery of the spine with higher rates of complications

A new study indicates that bone morphogenetic protein (BMP, a biological agents for the development of the creation of the bone) is 25 percent of the fusion of the spine and is associated with a higher rate of complications merger cases, which do not use BMP, and most of the hospital for all types of mergers in the spinal cord, according to a report of the July 1st edition of JAMA.

Back pain is one of the leading causes of disability in the United States and is one of the most common causes of Research after evaluation by a doctor, only the cold. "Nonsurgical interventions first line treatment but many patients progress in the surgical treatment of option 1, including the merger. Spinale Spinal fusion (merger) as a treatment for back pain quickly with development of instrumentation and spinal cord biological advances for the promotion of bone fusion, "write the authors.

According to information provided in the article, BMPs promote bone creation and processing and clinical use of recombinant protein, BMP has been approved by the U.S. Food and Drug Administration (FDA) in 2002 for the surgery lumbar spine prior to the fusion of the bones. Current prices and models for use of BMP clinic since the introduction of more than 5 years are not known at the national level and the population has no data available. In addition, complications and implications of the use of national BMP has not been evaluated.

P. Kevin Cahill, MD, Ph.D., MPH, of Brigham and Women's Hospital, Boston, and colleagues examined national trends in the adaptation of BMP in clinical practice since 2002 and the association between BMP and post-operative complications, length of stay and hospital costs. The analysis of data on 328,468 patients, the fusion process in the spinal cord 2002-2006, the Nationwide stationary sampling database, a 20 percent sample of U.S. community hospitals.

The researchers found that during the direct comparison of post-operative hospital complications for the year 2006 among the patients, spinal fusion using BMP status, no difference in kidney, breast, cervical or back of the case. After additional analysis, the use of BMP to the front of the neck fusion was related to a higher rate of occurrence of complications (7.09% to 4.68% vs without BMP BMP) with the main increase in injury-related complications (1.22% vs with BMP. without BMP 0.65%) and dysphagia (difficulty swallowing) or hoarseness (4.35% to 2.45% vs without BMP BMP). BMP was more related to stationary hospital costs in all categories of the merger. Increases of 11% and 41% of total hospital costs were, with the largest percentage increase of view before neck-fusion.

Study results also showed that land use BMP is 0.69 percent of all mergers in 2002 to 24.89 per cent of all mergers in 2006. The use of BMP include patient sex, race, and primary payer with increased use among women, Medicare patients and reduces the use of nonwhite patients.

"In summary, this report on the implementation of robust federal BMP fusion in the spinal cord in the first 5 years of clinical use since FDA. The impact on the development of complications of cancer of the cervix prior to the merger, and the increased length of stay and hospital costs highlight the need to further develop refining guidelines for use and consideration of long-term risks and benefits the use, "the authors conclude.