With the advances in medical technology and genetically engineered messengers, spinal fusion surgery has become less painful and more likely to succeed.

Under normal circumstances, these messengers are found in bone and other tissues and are called bone morphogenetic proteins, or BMPs for short. However, when these BMPs are placed in the body, they attract immature, shape-shifting cells from the blood, called stem cells, which then are able to turn into bone cells.

Researchers are now working on the possibility of using BMPs in helping the body form new bone and avoid the need for painful hip bone grafts currently required for spinal fusion surgery. This type of surgery is mainly used to treat people with severe back pain due to worn-out vertebrae caused by arthritis or injury, and usually found in the lower spine.

According to Matthew F. Gornet, MD, of the Missouri Bone and Spine center, spinal fusion surgery opens up a whole realm of treatment possibilities that have not been studied yet, which he finds very exciting.

Yet one of these possibilities that had already been studied has been reported by Gornet at the meeting of the North American Spine Society (NASS).

Spinal fusion surgery is a procedure that requires the removal of bone from the hip to be used as a graft to fuse the vertebrae together, thus relieving pressure on the spinal nerves. These bone grafts currently consist of bone taken from the hip in a separate operation, often causing long-term hip pain. Gornet and his colleagues at 16 spinal centers looked at whether BMP could be used in place of bone grafts.

Since early trials revealed that it could work, Gornet's team shows that a specially shaped cage made of titanium, a new product called ?LT-CAGE? and loaded with BMP works at least as well as frames loaded with natural bone. The LT-CAGE and BMP product are made by Medtronic.

In the study, the 279 people underwent the least traumatic form of spinal fusion surgery, in which the surgeon operates on the back through a relatively small cut in the abdomen. Fifty percent of the patients got the BMP-loaded frame, and the other fifty percent got frames loaded with hip bone grafts. Those who were getting the natural bone grafts did better than expected, nearly 89% of them had complete spinal fusion. But those getting the BMP material, called ?InFUSE,? did even a little better, which is about 95% complete spinal fusion.

Those who received the InFUSE grafts spent less time in surgery and had less blood loss. They also completely avoided bone removal from their hip, an extra operation that left about one-third of the bone-graft people with lasting pain.

Both groups had more than a 50% improvement in their pain following surgery.

Studies continue to monitor progress and development to compare the InFUSE system with bone graft in people who undergo the more traumatic spinal fusion surgery in which the surgeon must get to the spine from the back.