Comparative Complications Associated With BMP Use In Patients Undergoing ACDF for Degenerative Spinal Conditions: Systematic Review and Meta-Analysis.

Autor:	Martin CT; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA., Holton K; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA., Broida SE; Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA., Hickmann AK; Department of Neurosurgery, Kantonsspital St.Gallen, Switzerland., Bakker C; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA., Lender PA; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA., Watanabe K; Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan., Meisel HJ; Department of Neurosurgery, BG Klinikum Bergmannstrost Halle, Germany., Buser Z; Gerling Institute, Brooklyn, NY, USA.; Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, NY, USA., Presciutti SM; Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, NY, USA., Yoon ST; Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2024 Feb; Vol. 14 (2_suppl), pp. 94S-109S.
DOI:	10.1177/21925682231166325
Abstrakt:	Study Design: Systematic Review and Meta-Analysis. Objectives: To compare complication incidence in patients with or without the use of recombinant human Bone Morphogenic Protein-2 (BMP2) undergoing anterior cervical discectomy and fusion (ACDF) for degenerative conditions. Methods: A systematic search of eight online databases was conducted using PRISMA guidelines. Inclusion criteria included English language studies with a minimum of 10 adult patients undergoing instrumented ACDF surgery for a degenerative spinal condition in which BMP2 was used in all patients or one of the treatment arms. Studies with patients undergoing circumferential fusions, with non-degenerative indications, or which did not report post-operative complication data were excluded. Patients with and without BMP2 were compared in terms of the incidence of dysphagia/dysphonia, anterior soft tissue complications (hematoma, seroma, infection, dysphagia/dysphonia), nonunion, medical complications, and new neurologic deficits. Results: Of 1832 preliminary search results, 27 manuscripts were included. Meta-analysis revealed the relative risk of dysphagia or dysphonia (RR = 1.39, CI 95% 1.18 - 1.64, P = <.001), anterior soft tissue complications (RR = 1.43, CI 95% 1.25-1.64, P = <.001), and medical complications (RR = 1.32, CI 95% 1.06-1.66, P = .013) were statistically significant in the BMP2 group while the relative risk of non-union (RR = .5, CI 95% .23 - 1.13, P = .09) trended lower in the BMP2 group. Neurological deficit (RR = 1.06, CI 95% .82-1.37, P = .66), and additional medical complications (RR = 1.53, CI 95% .98-2.38, P = .06) were not found to be statistically different between the groups. Conclusions: This meta-analysis identified a high rate of arthrodesis when BMP2 was used in ACDF, but confirmed increased rates of dysphagia and anterior soft tissue complications. Surgeons may consider reserving BMP2 implementation for cases with a high risk of non-union, and should be aware of the risk of airway compromise. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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