Subject: Draft Health Technology Assessment: BMP for Spinal Fusion
To Whom it May Concern:
On behalf of the American Association of Neurological Surgeons (AANS) and the Congress of
Neurological Surgeons (CNS), we would like to thank the Washington State Health Care Authority for the
opportunity to comment on the draft Health Technology Assessment (HTA) regarding the use of
recombinant human Bone Morphogenetic Protein (rhBMP2 and rhBMP7). We appreciate the efforts of
your team in developing a very thorough review of the published literature reporting on the use of BMP
as an adjunct to spinal fusion.
We believe rhBMPs are a comparably safe and effective bone graft alternative appropriate in
patients with medical indications as determined by their treating surgeon. FDA approval of the onlabel indications of rhBMP noted equivalent or superior fusion rates, shorter operative times, and
decreased bone graft donor site complications. Our assessment of the literature would indicate that
rhBMPs are appropriate bone graft options for single level anterior (ALIF) and posterior (PLIF) lumbar
interbody fusion, and can also be considered an appropriate bone graft substitute in single-level
posterolateral lumbar fusion.
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