Current Trends in Recombinant Human Bone Morphogenetic Protein 2 (rhBMP2) Usage for Spinal Fusion Surgery

Area of Science:

• Spine Surgery
• Biomaterials
• Orthopedic Surgery

Background:

• Recombinant human bone morphogenetic protein 2 (rhBMP2) is widely used in spinal fusion, with both on-label and off-label applications.
• Despite extensive research on rhBMP2's safety, efficacy, and economic impact, current trends in its usage patterns require further investigation.

Purpose of the Study:

• To evaluate current trends in the on-label and off-label use of rhBMP2 for spinal fusion surgery.
• To identify demographic and practice-based factors influencing rhBMP2 utilization.

Main Methods:

• A deidentified survey was distributed to international spine society members.
• Surgeons reported demographic information, surgical experience, and rhBMP2 usage for specific spinal fusion procedures.
• Responses were stratified by rhBMP2 user status and indication (on-label vs. off-label), with data analyzed using chi-square and Fisher's exact tests.

Main Results:

• 146 surgeons completed the survey (20.5% response rate).
• Fellowship-trained surgeons and those in the US were more likely to use rhBMP2.
• Regional variations in usage were observed, with higher rates in the Southeast and Midwest US.
• Non-US surgeons were more prone to using rhBMP2 for off-label indications.

Conclusions:

• rhBMP2 usage patterns in spinal fusion differ based on surgeon demographics, training, and geographic location.
• Off-label application of rhBMP2 in spinal fusion surgery is prevalent among practicing spine surgeons.