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November 18, 2009

Complications Associated With Use of Bone-Morphogenetic Proteins in Spinal Fusion Procedures

JAMA. 2009;302(19):2090-2091. doi:10.1001/jama.2009.1639

To the Editor: Dr Cahill and colleagues1 assessed the prevalence, complications, and hospital charges associated with use of bone-morphogenetic proteins (BMPs) in a retrospective study of patients undergoing spinal fusion procedures from 2002 to 2006. Citing a study by Tumialán et al,2 the authors stated that there is growing support for decreased complications with smaller doses of BMP. Although this may be true for early local complications that have been described following BMP use in cervical fusion (such as edema, respiratory distress, and hematoma), it seems unlikely for other complications of BMP use in spinal interbody fusions, such as transient bone resorption of vertebral bodies. Resorptions, which occurred within the first few weeks after spinal interbody fusion procedures assisted with BMP, have been clinically insignificant in some patients, but in others have resulted in serious complications (spacer subsidence, loss of correction, spacer dislodgement, and failure of spinal fusion).3

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