From 2003 to 2009, recombinant human bone morphogenic protein use in pediatric spinal fusion increased from use in 2.7 percent of cases to 9.3 percent of cases, with an average increase of 16 percent per year, according to a new study published in the Journal of Bone and Joint Surgery.
Data on the 3.4-fold increase in BMP use came from the Nationwide Inpatient Sample database where 4,817 children were identified who underwent spinal fusion surgery during that period. The researchers found from 2003 to 2009:
1. Adjusted odds of BMP use were increased 1.3 fold for congenital scoliosis.
2. Adjusted odds of BMP use increased 2.8-fold for thoracolumbar fractures.
3. Adjusted odds of BMP use increased 5-fold for spondylolisthesis.
4. When patients had private insurance they were 1.5-fold more likely to receive BMP.
5. Among patients who received autograft bone intraoperatively there was a 0.63-fold decrease in BMP use.
6. BMP use was 0.38-fold lower in teaching hospitals.
7. BMP use was 1.7-fold higher in hospitals with large bed capacity.
8. Hospitals in the west had a 1.7-fold increase in BMP use when compared with hospitals in the northeast.
9. Hospitals in the south experienced a two-fold increase in the odds of using BMP.
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