RT Journal
A1 Smoljanovic T, Siric F, Bojanic I
T1 COmplications associated with use of bone-morphogenetic proteins in spinal fusion procedures
JF JAMA
JO JAMA
YR 2009
FD November 18
VO 302
IS 19
SP 2090
OP 2091
DO 10.1001/jama.2009.1639
UL http://dx.doi.org/10.1001/jama.2009.1639
AB 
To the Editor: Dr Cahill and colleagues1 assessed the prevalence, complications, and hospital charges associated with use of bone-morphogenetic proteins (BMPs) in a retrospective study of patients undergoing spinal fusion procedures from 2002 to 2006. Citing a study by Tumialán et al,2 the authors stated that there is growing support for decreased complications with smaller doses of BMP. Although this may be true for early local complications that have been described following BMP use in cervical fusion (such as edema, respiratory distress, and hematoma), it seems unlikely for other complications of BMP use in spinal interbody fusions, such as transient bone resorption of vertebral bodies. Resorptions, which occurred within the first few weeks after spinal interbody fusion procedures assisted with BMP, have been clinically insignificant in some patients, but in others have resulted in serious complications (spacer subsidence, loss of correction, spacer dislodgement, and failure of spinal fusion).3