5 Tests to Avoid in Back Pain

Nathan Wei, MD; Bret S. Stetka, MD


November 06, 2013

In This Article

Rethinking Bone Morphogenetic Protein

The Recommendation: Do not use recombinant human bone morphogenetic protein (rhBMP) in routine anterior cervical spine fusion surgery.

The Rationale: rhBMPs are a group of growth factors that control tissue architecture throughout the body, including stimulating formation and healing. Although these compounds, particularly rhBMP type 2, have been used in numerous orthopedic applications, life-threatening complications have been reported with routine use of recombinant human rhBMP in anterior cervical spine fusion surgery, owing to swelling of the soft tissues. This may lead to difficulty swallowing or pressure on the airway.

Dr. Wei's Bottom Line: BMP initially showed promise as an adjunct to help with healing. It was also explored as a possible disease-modifying therapy for osteoarthritis. Unfortunately, the formation of ectopic bone, with its attendant risks and complications, has dampened the enthusiasm for this protein. Until further studies demonstrate that BMP can be used without incurring complications, it will rest on the back burner.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.