Device More Effective Than Iliac Crest Bone Graft for Fusion
It delivers a bone growth-promoting protein in spinal fusion
MONDAY, Dec. 22 (HealthDay News) -- A bone graft device that delivers a bone growth-promoting protein is safe and more effective than iliac crest bone graft (ICBG) in promoting spinal fusion in older adults, according to a report in the Dec. 15 issue of Spine.
Steven D. Glassman, M.D., from the University of Louisville in Kentucky, and colleagues randomly assigned 102 patients over 60 years old undergoing posterolateral lumbar fusion to recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS, Infuse Bone Graft) or ICBG. They note that rhBMP-2/ACS was approved by the U.S. Food and Drug Administration in 2002 as a replacement for ICBG for anterior lumbar interbody fusion, but has been widely used off label for posterolateral spinal fusion or transforaminal lumbar interbody fusion.
Two years after surgery, the researchers found that health-related quality-of-life outcomes improved similarly in both groups, as assessed by the Oswestry Disability Index, Short Form-36 physical component score, and numerical rating scales for back pain and leg pain. However, the rhBMP-2/ACS group had a significantly better fusion grade on computed tomography scan, fewer complications and a lower revision rate. The mean two-year cost in the rhBMP-2/ACS group was also lower, at $40,131 compared with $42,574 for ICBG.
"RhBMP-2/ACS is a viable ICBG replacement in older patients in terms of safety, clinical efficacy and cost-effectiveness," Glassman and colleagues conclude.