Resident, PGY5 Henry Ford Health System, Department of Neurological Surgery Henry Ford Hospital Detroit, MI, US
Introduction: A key component of spinal fusion is the graft material used to promote arthrodesis. rhBMP2 has demonstrated robust fusion efficacy but is accompanied by complications and high cost. Cellular-based matrices (CBM) have been adopted with theoretical osteogenic properties, but also are costly. OsteoAMP (Bioventus), which is a differentiated allograft that purports osteogenic properties but with lower cost. In this study, we compare the radiographic outcomes of fusion at 6 months and 12 months between OsteoAMP compared to other CBMs.
Methods: Two hundred ninety patients from a single center who underwent lumbar spine fusion were retrospectively analyzed for radiographical signs of fusion. 173 patients (59.6%) received OsteoAMP, while all other patients in the control CBM group received Viacell (Globus medical), Vivigen (LifeNet Health), or Osteocel (NuVasive). Patients’ lumbar spine CTs at 6 months and 12 months post-surgery were evaluated for the primary outcome of fusion. Signs of fusion were deemed present if there was continuous bony density across either the intervertebral space or posterior elements. Odds ratios were calculated to compare rates of fusion.
Results: At 6 months, 69.3% and 64.2% of the OA and Control groups demonstrated signs of fusion, respectively. At 12 months, these values increased to 81.8% and 83.9% respectively. A two-sample t-test at both time points showed p-values > .05. Logistic regression was performed and included age, sex, and race as covariates. The odds ratio for signs of fusion in the OA-group was 1.26 (95% CI: [0.75, 2.12]; p > 0.05) at 6 months and 0.95 (95% CI: [0.50, 1.77] ; p > 0.05) at 12 months
Conclusion : We found no statistical difference between CBMs and OsteoAMP for fusion at 6-month and 12-month post-surgery. While costs of CBMs can vary by vendor, using an alternative with differentiated allografts represents a potential cost savings without sacrificing efficacy and thus more value.
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