BMP Fusion

The genetically engineered spine fusion

Spine fusion is a commonly performed procedure uniting two or more motion segments of the human spine. This process has traditionally involved taking bone from one part of the patient’s anatomy and moving it to another or alternatively borrowing bone from a cadaver and transplanting it into the patient. However, the transplanted bone (from the patient or cadaver) does not form an instantaneous fusion. Essentially, the bone graft is converted by the body into a solid mass of bone uniting the motion segments. What are the problems associated with fusion? First, bone graft harvested from one location (commonly the pelvis) can produce pain. Second, bone graft (from the patient or cadaver) does not always convert into a solid fusion.

Two proteins that help stimulate the fusion process have been discovered – bone morphogenetic proteins (BMP-2 and BMP-7). These proteins are found naturally in the human body. In 1988, these proteins were identified and re-produced with genetic engineering. Experimentation with the genetically reproduced proteins led scientist to realize that they (BMP-2) could stimulate bone formation. In 1997, genetically created BMP was used in patients undergoing spine fusion on an experimental basis. Further studies are currently being used to evaluate the full spectrum of use of BMP in all forms of fusion.

In July 2002, the FDA approved the initial use of BMP in a special circumstance combined with a cage inserted into the disc space in the lumbar spine. Infuse Bone Graft/LT-CAGE Lumbar Tapered Fusion Device marries the genetically engineered BMP and spine cages based upon a multi-center study showing high fusion rates with this specific use. The rhBMP-2 is reconstituted with sterile water and placed on collagen sponges. The sponges are placed into the LT-cages and then the cages are inserted into the disc space. The study found 94.5 percent fused.

The next time that someone suggests a fusion, consider the fusion genie in the bottle.

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