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Research ArticleLumbar Spine

Bone Morphogenetic Protein in Anterior Lumbar Interbody Fusions: A Propensity-Matched Medicare Outcome Analysis

Syed I. Khalid, Ravi S. Nunna, Rachyl M. Shanker, Kyle B. Thomson, Rown Parola, Owoicho Adogwa and Ankit I. Mehta
International Journal of Spine Surgery August 2022, 16 (4) 706-713; DOI: https://doi.org/10.14444/8301
Syed I. Khalid
1 Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
2 Surgery, Rush University Medical Center, Chicago, IL, USA
MD
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Ravi S. Nunna
1 Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
MD
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Rachyl M. Shanker
3 Chicago Medical School, North Chicago, IL, USA
MD
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Kyle B. Thomson
3 Chicago Medical School, North Chicago, IL, USA
BS
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Rown Parola
1 Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
MS
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Owoicho Adogwa
4 Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
MD, MPH
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Ankit I. Mehta
1 Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
MD
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    Figure 1

    Patient selection flow chart. ALIF, anterior lumbar interbody fusion; BMP, bone morphogenetic protein.

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    Figure 2

    Kaplan-Meier plot for pseudarthrosis and revision surgery occurring within 2 y postoperatively. BMP, bone morphogenetic protein.

Tables

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    Table 1

    Propensity-matched characteristics of patients undergoing single-level anterior lumbar interbody fusion surgeries.

    ParametersTotal, n = 22,110BMP Utilized in Procedure, n = 8971No BMP Utilized in Procedure, n = 13,139 P Value
    Age, n (%)<0.05
     65–699308 (42.1)3920 (43.7)5388 (41.0)
     70–746899 (31.2)2766 (30.8)4133 (31.5)
     75–794194 (19.0)1658 (18.5)2536 (19.3)
     80–841709 (7.7)627 (7.0)1082 (8.2)
    Sex, n (%)0.77
     Male8007 (36.2)3238 (36.1)4769 (36.3)
     Female14,103 (63.8)5733 (63.9)8370 (63.7)
    Comorbidities, n (%)
     Body mass index >30 kg/m2 1183 (5.4)469 (5.2)714 (5.4)0.52
     Diabetes mellitus4540 (20.5)1725 (19.2)2815 (21.4)<0.05
     Chronic kidney disease865 (3.9)340 (3.8)525 (4.0)0.46
     Hypertension11,575 (52.4)4601 (51.3)6974 (53.1)<0.05
     Rheumatoid arthritis651 (2.9)279 (3.1)372 (2.8)0.24
     Osteoporosis1947 (8.8)814 (9.1)1133 (8.6)0.26
     Smoking2159 (9.8)853 (9.5)1306 (9.9)0.30
    Postoperative complications, n (%)
     Pseudarthrosis352 (1.6)174 (1.9)178 (1.4)<0.05
     Revision surgery789 (3.6)330 (3.7)459 (3.5)0.49
    • Abbreviation: BMP, bone morphogenetic protein.

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    Table 2

    Propensity-matched odds of complications among bone morphogenetic protein treatment cohort who underwent single-level anterior lumbar interbody fusion surgeries compared with the control cohort.

    Postoperative ComplicationsOR (95% CI)
    Pseudarthrosis1.44 (1.16–1.76)
    Revision surgery1.06 (0.91–1.22)

Supplementary Materials

  • Figures
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  • Table S1.

    [8301supp001.docx]

  • Table S2.

    [8301supp002.docx]

  • Table S3.

    [8301supp003.docx]

  • Table S4.

    [8301supp004.docx]

  • Table S5.

    [8301supp005.docx]

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International Journal of Spine Surgery
Vol. 16, Issue 4
1 Aug 2022
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Bone Morphogenetic Protein in Anterior Lumbar Interbody Fusions: A Propensity-Matched Medicare Outcome Analysis
Syed I. Khalid, Ravi S. Nunna, Rachyl M. Shanker, Kyle B. Thomson, Rown Parola, Owoicho Adogwa, Ankit I. Mehta
International Journal of Spine Surgery Aug 2022, 16 (4) 706-713; DOI: 10.14444/8301

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Bone Morphogenetic Protein in Anterior Lumbar Interbody Fusions: A Propensity-Matched Medicare Outcome Analysis
Syed I. Khalid, Ravi S. Nunna, Rachyl M. Shanker, Kyle B. Thomson, Rown Parola, Owoicho Adogwa, Ankit I. Mehta
International Journal of Spine Surgery Aug 2022, 16 (4) 706-713; DOI: 10.14444/8301
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More in this TOC Section

  • Comparison of Stand-Alone Anterior Lumbar Interbody Fusion, 360° Anterior Lumbar Interbody Fusion, and Arthroplasty for Recurrent Lumbar Disc Herniation: Focus on Nerve Decompression and Painful Spinal Instability Resolution
  • Recovery Trajectories After Lumbar Fusion Stratified by Baseline Patient-Reported Outcomes Measurement Information System Physical Function Disability Levels
  • Association Between Nonsteroidal Anti-inflammatory Drugs Use and Surgical Outcomes Following Posterior Lumbar Fusion: A Medical Claims Database Analysis
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Keywords

  • bone morphogenetic protein
  • complication, postoperative
  • fusion
  • lumbar
  • pseudarthrosis

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