I am going to have spinal fusion surgery next week. The surgeon wants to use some bone growth to help me heal faster. I’m all for that but is there anything I should know about this stuff before signing the agreement form?

You may be referring to bone morphogenetic protein known as BMP-2 or BMP for short. BMP is a growth factor (protein) that helps bone heal and promotes bone fusion. It reportedly helps speed up the recovery rate after spinal fusion. BMP is designed to promote bone formation by setting up an inflammatory reaction. This type of enhancer was developed to avoid problems that occur with traditional bone grafting.

There are potential complications with any surgical procedure. Wound infection, hematomas (pockets of pooled blood), blood clots, and even death can occur. Older adults, especially those with other comorbidities (other health problems) such as diabetes, heart disease, or lung conditions may be at increased risk from blood clots, stroke, and pneumonia. In rare cases, death from any of these more serious conditions can occur after surgery.

Spinal fusion has a few complications all of its own — depending on how the procedure is done. For example, fusion from the front (anterior approach) of the cervical spine (neck) can cause damage to the vocal cords. Incision and surgery from the back (posterior approach) can create injury to the spinal cord or nerves to the arms and legs leaving the spinal cord.

In the case of bone morphogenetic protein (BMP), the bone growth can be “too” successful. In other words, there can be an overgrowth of bone called ectopic bone. The extra bone can press on nerve tissue causing problems.

But according to a recent study of almost 12,000 patients the risk of complications is the same with or without BMP. The one exception occurs when BMP is used for anterior cervical spinal fusions. Wound infection and hematoma formation were the two most common problems associated with anterior cervical spinal fusion using BMP.

All other spinal fusions with and without BMP had an equal number of complications (around eight per cent for both groups). This is an important finding because if the risk of using BMP during spinal fusions is greater than the benefit, then the surgeon may not want to use BMP. Factors of this type must be taken into consideration when planning spinal fusion procedures.

The authors concluded from this study that using BMP as a bone enhancer to foster bone fusion does not increase the risk of complications. This is true EXCEPT when the procedure is an anterior cervical spine (neck) fusion. Your surgeon will advise you according to all of your own individual factors (age, general health, type of surgery). Don’t hesitate to ask him or her this question. With this information in hand, you will be better prepared to understand the procedure and clear up any other questions you might have.