Letters

摘要

The Scoliosis Research Society (SRS) Morbidity and Mortality (M&M) registry is a large, potentially powerful resource in understanding risks related to rhBMP-2 use. This review of SRS registry complications associated with the use of bone morphogenetic proteins (BMPs) is particularly interesting and timely because of recent description of method-ologic shortcomings in trials of rhBMP-2. Unfortunately, the article missed opportunities to add perspective on this issue. Recent reviews have identified several serious complications of rhBMP-2 use. Not surprisingly, the SRS registry was not designed to track all these possible complications. Specifically, Carragee et al cited the incidence of osteolysis with implant subsidence, bone overgrowth, retrograde ejaculation associated with anterior lumbar interbody fusion surgery, neurologic injury risks, and infections. Williams et al discussed only the last 2, noting a high incidence of both problems with anterior cervical discectomy and fusion (ACDF) but no significant differences for other procedures. The validity of these conclusions depends on the intent of the registry, the design of the registry, the statistical analysis used in this article, and the presentation of results. We have concerns in each of these areas.