骨形态发生蛋白（BMP）在脊柱手术中促进关节融合的应用越来越广泛。由于BMP能够刺激细胞增殖，与其致癌的关联性备受关注。以前的研究对接受BMP治疗的患者癌症风险的结论存在分歧。作者旨在比较接受脊柱关节融合手术的患者中应用或不应用BMP的固体器官和造血恶性肿瘤发生率。使用PearlDiver Mariner患者索赔数据库查询了2015年至2021年间接受胸腰椎融合手术的患者。排除了存在既往恶性肿瘤的患者。分析了脊柱手术后诊断出的固体器官肿瘤和造血恶性肿瘤的发生率。使用年龄、性别、吸烟情况和手术年份进行倾向评分匹配，比较接受和不接受BMP治疗的患者。在没有既往固体器官肿瘤的患者中，有22,139名患者接受了BMP治疗，306,249名患者没有接受。在倾向评分匹配组中，BMP组有3.1%的患者术后发生固体器官肿瘤，非BMP组有3.5%的患者。暴露于BMP后发生固体器官肿瘤的相对风险（RR）为0.89（95%置信区间0.81-0.98，p = 0.02）。在没有既往造血恶性肿瘤的患者中，有23,505名患者接受了BMP治疗，328,796名患者没有接受。在倾向评分匹配组中，BMP组有0.4%的患者发生造血恶性肿瘤，非BMP组有0.6%的患者。接受BMP治疗后发生造血恶性肿瘤的相对风险（RR）为0.71（95%置信区间0.55-0.93，p = 0.015）。胸腰椎融合中使用BMP与新发恶性肿瘤风险增加无关，这进一步支持有关使用BMP与恶性肿瘤增加缺乏相关性的新兴数据。

Bone morphogenetic protein (BMP) has been increasingly used in spinal surgery to promote arthrodesis. Because BMP stimulates cellular proliferation, its association with tumorigenesis is a concern. Previous research has generated conflicting conclusions on the risk of cancer in patients receiving BMP. The authors aimed to compare the incidence of solid organ and hematopoietic malignancies in patients undergoing spinal arthrodesis with or without BMP.The PearlDiver Mariner Patient Claims Database was queried for patients undergoing thoracolumbar fusion between 2015 and 2021. Patients with preexisting malignancy were excluded. Data were analyzed for incidence of solid organ malignancy and hematopoietic malignancy diagnosed after spinal surgery. Propensity score matching using age, sex, tobacco usage, and year of surgery was performed between patients who did and those who did not receive BMP.Among patients without prior solid organ malignancy, BMP was used in 22,139 patients and not used in 306,249. In the propensity score-matched group, 3.1% of the BMP group developed solid organ malignancy following surgery compared with 3.5% in the non-BMP group. The relative risk (RR) of developing solid organ malignancy after BMP exposure was 0.89 (95% CI 0.81-0.98, p = 0.02). Among patients without prior hematopoietic malignancy, BMP was used in 23,505 patients and not used in 328,796 patients. In the propensity score-matched group, 0.4% of the BMP group developed hematopoietic malignancy compared with 0.6% of the non-BMP group. The RR of developing hematopoietic malignancy after BMP exposure was 0.71 (95% CI 0.55-0.93, p = 0.015).BMP use in thoracolumbar fusion was not associated with an increased risk of new malignancy, which further supports emerging data on the lack of an association between BMP use and increased malignancy.