Should I go ahead and agree to let the surgeon use the special bone growth sponges available now for my spinal fusion? After reading the list of all the things that can go wrong, I’m not so sure it’s a good idea.

BMP is a naturally occurring protein that scientists have discovered can be a replacement for bone grafts. This is a good way to avoid some of the painful problems that can occur when bone is harvested from some other part of the patient’s body.

But as with most surgical procedures, there is a list of adverse effects suffered by patients as a result of the surgery. Bone resorption, inflammation, leg pain from radiculitis, breathing problems, infection, swelling and fluid collections, too much bone growth or bone growth into the soft tissues, and blood clots are just a few of the complications reported.

Data is available on both neck and lumbar spinal fusions. Some adverse effects are specific to the location of the fusion. For example, dysphagia (difficulty swallowing) can occur with cervical spine fusions. And retrograde ejaculation has been reported with anterior lumbar spine fusions.

Half of all patients who develop adverse effects from the use of BMP in spinal fusion end up having another (revision) surgery to deal with the problem. Some of the problems encountered are potentially life-threatening, so there is a need to pay close attention to these reports of adverse effects.

But reports of problems and complications after spinal fusion using BMP don’t necessarily mean the BMP was a direct cause of these effects. There are some serious adverse effects from BMP for sure but not all problems can be linked to this device.

More studies are needed to take a closer look at whether these reported events are, in fact, device-related adverse effects. Maybe the patients would have developed these problems as a result of the surgery and they have nothing to do with the use of the BMP. And it would be helpful if researchers could identify risk factors for adverse events associated with the use of BMP in spinal fusion.

Until more is known about the true risks and safety concerns about BMPs, surgeons are advised to be aware of potential problems and discuss them ahead of time with their patients. Using the products according to the manufacturer’s directions may help ensure safe and effective use of BMP. Inappropriate and off-label uses should be avoided until safety issues have been resolved.