Twenty-Year Retrospective Analysis of Bone Morphogenetic Protein (BMP) Use in Anterior Cervical Fusion: Incidence of Severe Dysphagia and Airway Complications in a Single-Surgeon Study.
Brianna N Hebeka, Jennifer A Reilly, Amaya J Jones, Charles C Edwards
{"title":"Twenty-Year Retrospective Analysis of Bone Morphogenetic Protein (BMP) Use in Anterior Cervical Fusion: Incidence of Severe Dysphagia and Airway Complications in a Single-Surgeon Study.","authors":"Brianna N Hebeka, Jennifer A Reilly, Amaya J Jones, Charles C Edwards","doi":"10.1097/BSD.0000000000002175","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, nonrandomized.</p><p><strong>Objective: </strong>The objective of this study is to assess the incidence of severe swallowing and airway complications in patients who underwent anterior cervical discectomy and fusion (ACDF) with low-dose bone morphogenetic protein (BMP) by a single surgeon.</p><p><strong>Summary of background data: </strong>The FDA released a black box warning against the use of BMP in ACDF surgeries in 2008, but few studies have reported the incidence of complications cited in the warning. Further, few studies have longitudinally tracked the use of low-dose BMP in the cervical spine and reported complication rates. This study aims to fill a gap in the literature by providing a 20-year longitudinal review of the use of low-dose BMP by a single surgeon.</p><p><strong>Methods: </strong>The retrospective analysis assessed patients who underwent ACDF surgeries from 2003 to 2023 by a single surgeon. Patient demographics and surgical characteristics were identified. Complications, as defined by the FDA Black Box Warning, were prospectively recorded. Statistical analysis included binary logistic regressions to predict complications.</p><p><strong>Results: </strong>One thousand ten patients were included in this study. 2.2% of the patients developed a Black Box Complication. In response to these complications, 1.5% of patients received intravenous steroids, 0.2% of patients were reintubated, 0.2% of patients underwent second surgeries to drain the surgical site, and 2.1% of patients were readmitted for swallowing or airway complications. No patients required a tracheostomy.</p><p><strong>Conclusions: </strong>The complication rates of the current study are comparable to the published rates of ACDF procedures without BMP. Given the current study and the growing body of evidence supporting the safety and efficacy of low-dose BMP, categorical cautions against the use of BMP in the cervical spine should be reconsidered.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Spine Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BSD.0000000000002175","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Study design: Retrospective, nonrandomized.
Objective: The objective of this study is to assess the incidence of severe swallowing and airway complications in patients who underwent anterior cervical discectomy and fusion (ACDF) with low-dose bone morphogenetic protein (BMP) by a single surgeon.
Summary of background data: The FDA released a black box warning against the use of BMP in ACDF surgeries in 2008, but few studies have reported the incidence of complications cited in the warning. Further, few studies have longitudinally tracked the use of low-dose BMP in the cervical spine and reported complication rates. This study aims to fill a gap in the literature by providing a 20-year longitudinal review of the use of low-dose BMP by a single surgeon.
Methods: The retrospective analysis assessed patients who underwent ACDF surgeries from 2003 to 2023 by a single surgeon. Patient demographics and surgical characteristics were identified. Complications, as defined by the FDA Black Box Warning, were prospectively recorded. Statistical analysis included binary logistic regressions to predict complications.
Results: One thousand ten patients were included in this study. 2.2% of the patients developed a Black Box Complication. In response to these complications, 1.5% of patients received intravenous steroids, 0.2% of patients were reintubated, 0.2% of patients underwent second surgeries to drain the surgical site, and 2.1% of patients were readmitted for swallowing or airway complications. No patients required a tracheostomy.
Conclusions: The complication rates of the current study are comparable to the published rates of ACDF procedures without BMP. Given the current study and the growing body of evidence supporting the safety and efficacy of low-dose BMP, categorical cautions against the use of BMP in the cervical spine should be reconsidered.
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
