• Hyung Rae Lee, Dong-Ho Lee, Sang Yun Seok, In Hee Kim, Jae Hwan Cho, and Chang Ju Hwang.
• Department of Orthopedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Republic of Korea.
• World Neurosurg. 2024 Mar 1; 183: e3e10e3-e10.

ObjectiveRecombinant human bone morphogenetic protein-2 (rhBMP-2) is effective for promoting robust fusion for long-level cervical deformity and revision surgeries. However, only a few studies have reported its efficacy and complications in posterior cervical fusion (PCF).MethodsTherefore we evaluated the efficacy and complications of rhBMP-2 application in PCF surgery by searching 3 electronic databases (PubMed, Cochrane Database, and EMBASE) for studies that evaluated the use of rhBMP-2 in PCF. Five studies (1 prospective and 4 retrospective) were included in the meta-analysis.ResultsThe quality of each study was assessed, and data on pseudarthrosis, wound infection, neurologic, and immediate medical complications were extracted and analyzed. We found that the use of rhBMP-2 in PCF showed significant benefits in terms of pseudarthrosis and no significant increases in the risk for neurologic and immediate medical complications regardless of the dose. However, high-dose (>2.1 mg/level) rhBMP-2 was a risk factor for wound infection after PCF.ConclusionsOur meta-analysis of the currently available literature suggests that patients with PCF may benefit from BMP-2 usage without increasing the risk of complications. However, dose control and containment are important to ensure a low risk of complications.Copyright © 2023. Published by Elsevier Inc.

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