Studies suggest that the use of bone morphogenetic protein (BMP) for spinal fusion has risen sharply over the past decade, increasing costs substantially with no evidence of improved outcomes.
Analysis of ~17,000 spinal fusion procedures to treat lumbar spinal stenosis revealed an increase of use from 5.5% of procedures in 2003 to 28.1% in 2008. BMP was more likely to be used in patients with previous surgery or those undergoing more complex spinal fusion. The results supported the safety of BMP, with no increase in major medical complications.
However, use of BMP did not reduce the need for repeat surgery. In both groups, ~3% of patients underwent repeat surgery within 1 year, and 6% at 2 years. Repeat surgery rates were similar for patients undergoing more complex spinal fusion with and without BMP.
Spinal fusion procedures using BMP were considerably more expensive, with an average increase of $15,000 in hospital charges. Under Medicare's Diagnosis-Related Group system, actual reimbursements were substantially lower (average difference $850).
Use of Bone Morphogenetic Proteins in Spinal Fusion Surgery for Older Adults With Lumbar Stenosis: Trends, Complications, Repeat Surgery, and Charges, Spine, February 1, 2012 - Volume 37 - Issue 3.
Sharp Rise in Use of Bone Growth Factor for Spinal Fusion Surgery. Wolters Kluwer Health, 1/31/12.