Assessment of Bone Growth Stimulator Is Mixed

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BMP -- a protein that the body naturally makes that tells stem cells to form bone -- was approved in 2002 by the U.S. Food and Drug Administration for use in spinal fusion surgeries in the lower back area. Because it promotes bone growth, BMP appears to be helpful in fusion surgeries because it may speed the process and possibly reduce the need for a second operation.

"When you do a fusion, you take out the disc and then you put in a graft so the bones fuse together," Cahill explained. "BMP accelerates this fusion. This is particularly important in some people -- such as smokers or people with diabetes -- who tend to heal slower to begin with. If it takes too long for the bones to fuse, it can be very painful and sometimes may make a second operation necessary."

For the study, Cahill and his colleagues reviewed data from more than 328,000 spinal fusion procedures that took place between 2002 and 2006 in hospitals across the country. They found that the use of BMP in fusion procedures went from less than 1 percent in 2002 to almost 25 percent by 2006.

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In most procedures, its use was not associated with an increased risk of complications. However, in procedures done on the front part of the neck, the risk of complications increased by 43 percent when BMP was used -- from about 5 to 7 percent.

The study also found that costs for spinal fusions were higher when BMP was used. Inpatient hospital charges ranged from 11 percent to 41 percent higher for procedures with BMP than for those in which the agent was not used, the study found.

"You need to have a reason to use BMP," said Dr. Frank P. Cammisa Jr., chief of spinal surgery at the Hospital for Special Surgery in New York City. "If there are risk factors or it's a revision surgery, then use it. But, you really need to have a good reason to use it."

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