Use of rh-BMP 2 in thoraco-lumbar pyogenic spinal infections: a French series of 20 patients and literature review

OBJECTIVE: Pyogenic spondylodiscitis is a serious disease whose incidence is increasing. Several studies have demonstrated the efficacy of surgical management by circumferential arthrodesis at the cost of autologous bone grafting, which is not without morbidity. In this first French series, we evaluated the safety and efficacy of rh-BMP 2 in pyogenic infections of the lower thoracic and lumbar spine. METHODS: This retrospective study included 20 patients operated on between January 2010 and December 2023 for pyogenic spondylodiscitis or spondylitis of the lower thoracic or lumbar region by circumferential arthrodesis with the use of rh-BMP 2 in interbody implants. An age-matched control group of 16 patients was included for comparison. RESULTS: Radiological fusion was observed in all patients at 6 months in the rh-BMP2 group. No complications specifically attributable to rh-BMP2 were observed during follow-up. In the control group, fusion was acquired at an average of 23 months (p = 0.02*). CONCLUSIONS: In this small retrospective series, the use of rh-BMP2 was associated with a high early fusion rate. However, these findings must be interpreted with caution given methodological limitations. Further prospective studies are required.