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Does Recombinant Human Bone Morphogenic Protein 2 Affect Perioperative Blood Loss after Lumbar and Thoracic Spinal Fusion?
Asian Spine Journal ; : 880-886, 2018.
Article in English | WPRIM | ID: wpr-739284
ABSTRACT
STUDY

DESIGN:

Retrospective cohort design.

PURPOSE:

This study aimed to determine whether recombinant human bone morphogenic protein 2 (rhBMP-2) reduces total perioperative blood loss during lumbar and thoracic fusion. OVERVIEW OF LITERATURE Previous studies on rhBMP-2 versus iliac crest bone grafting in thoracic and lumbar fusions have yielded mixed results regarding reductions in blood loss and have largely neglected the postoperative period when analyzing total blood loss. Additionally, these studies have been limited by heterogeneity and sample size.

METHODS:

We analyzed the blood loss patterns of 617 consecutive adult patients undergoing lumbar and/or thoracic fusions requiring subfascial drain placement at a single institution from January 2009 to December 2016. Patients were divided into BMP and non-BMP cohorts, and a propensity score analysis was conducted to account for the differences between cohorts.

RESULTS:

At a per-level fused basis, the BMP group exhibited a significant reduction in the intraoperative (66.1 mL per-level fused basis; 95% confidence interval [CI], 127.9 to 4.25 mL; p=0.036) and total perioperative blood loss (100.7 mL per-level fused basis; 95% CI, 200.9 to 0.5 mL; p=0.049). However, no significant differences were observed in an analysis when not controlling for the number of levels or when examining the postoperative drain output.

CONCLUSION:

RhBMP-2 appears to reduce both intraoperative and total blood loss during lumbar and thoracic fusions on a per-level fused basis. This total reduction in blood loss was achieved via intraoperative effects because RhBMP-2 had no significant effect on the postoperative drain output.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Postoperative Period / Spinal Fusion / Population Characteristics / Retrospective Studies / Cohort Studies / Bone Transplantation / Sample Size / Propensity Score Type of study: Etiology study / Incidence study / Observational study / Risk factors Limits: Adult / Humans Language: English Journal: Asian Spine Journal Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Postoperative Period / Spinal Fusion / Population Characteristics / Retrospective Studies / Cohort Studies / Bone Transplantation / Sample Size / Propensity Score Type of study: Etiology study / Incidence study / Observational study / Risk factors Limits: Adult / Humans Language: English Journal: Asian Spine Journal Year: 2018 Type: Article