An Option for Treating Degenerative Disc Disease
]]>Degenerative disc disease]]> (DDD), a significant cause of back pain in adults, is a disorder of the spine that can be quite debilitating. The spine is formed from 26 bones or vertebrae that are separated by intervertebral discs. These discs, which are cushion-like pads, act as shock absorbers during activity. In DDD, the discs become damaged, and may lead to back and leg pain. Spinal fusion surgery is sometimes used to treat DDD.
What Happens in Spinal Fusion Surgery
In ]]>spinal fusion]]> surgery, two or more vertebrae are "welded" together to eliminate the pain caused by the damaged disc in the spine. To do this, a doctor inserts pieces of the patient's own bone (usually harvested from the hip) between the vertebrae to prompt the body to grow new bone. This process requires two steps. The implanting the bone in the spine, and removing the small pieces of bone from the patient's hip. Some studies have shown that the bone-harvesting surgery can be more painful than the fusion surgery itself. The InFUSE Bone Graft eliminates the need for this bone-harvesting surgery.
How the Device Works
The device consists of three components split between two parts: a metallic tapered spinal fusion cage (LT-CAGE lumbar tapered fusion device) and a bone graft substitute (InFUSE Bone Graft). The InFUSE Bone Graft consists of a protein (rhBMP-2) and a carrier for the protein. These two components are placed inside the fusion cage.
rhBMP-2 is a genetically engineered version of a naturally occurring protein that is capable of initiating bone growth or bone regeneration in specific, targeted areas in the spine. The LT-CAGE stabilizes the spine, while the rhBMP-2 stimulates bone growth and the spine fuses.
What the Evidence Says
A multicenter, randomized, two-year study was conducted with 279 people with DDD. All the participants received the LT-CAGE device. Approximately half of the people received autograft bone, and the rest received InFUSE Bone Graft. The study demonstrated that the use of the LT-CAGE device with InFUSE Bone Graft was effective for promoting spinal fusion. A thorough discussion with your doctor to discuss the risks and benefits is necessary before undertaking this procedure.
American Academy of Orthopedic Surgeons
US Food and Drug Administration
The Arthritis Foundation
Burkus JK, et al. Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages.J Spinal Disord Tech. 2002;15(5):337-49.
Last reviewed June 2010 by ]]>Brian P. Randall, MD]]>
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