A biotechnological breakthrough in the field of bone building in spine surgery

An innovative medical technology developed by an Israeli company that is used for fusion and bone building during spinal fusion surgery

By: Prof. Yizhar Plouman, director of the Israeli Spine Surgery Center, Assuta Hospital

For many years, scientists have been looking for ways to encourage the human body to repair and create damaged bone, more quickly and efficiently. Most of all, it was surgeons specializing in spine surgery who valued the research on the subject the most. More than half of the thousands of bone fusion surgeries performed every year in the US are spinal fusion surgeries.

The first breakthrough was in the 60s, when the scientist Dr. Marshall Jurist first discovered the BMP protein, which is a growth factor for building new bone, similar to the natural process that occurs in the body. (Bone Morphogenetic Proteins) The protein affects the formation and building of the bone. Dr. Jurist pointed out: "The BMP protein is designed to cause bone formation to be under the doctor's control." In the 80s, the protein was created genetically for the first time. The first surgery that included bone building in the back was in 1997.

The accepted traditional treatment is taking a local bone graft (BONE GRAFT) from the pelvic bone during surgery to fix the vertebrae of the spine, and transplanting it between the vertebrae in order to encourage new bone formation. This process includes opening another surgical site which increases the risk of infections and blood loss and may cause persistent local pain.

Although this is an effective procedure in some cases of spinal diseases, it prolongs the operation time, the recovery time, increases blood loss, risk of infections, and increases pain during recovery. In addition, not always. In addition, the results of local bone grafting are not always satisfactory in the context of vertebral fusion and sufficient bone formation.

A new technology of creating protein through a genetic process, which encourages bone growth as in the natural process of the body, is a breakthrough in the field of spinal fixation surgeries in which bone building is required, successfully implemented in private hospitals in Israel and the USA and is considered a standard of care.

The "Infuse" - INFUSE is a biological bone substitute, produced by genetic engineering, the fruit of an exclusive development by the Medtronic company, which enables the fusion of the vertebrae, and is an alternative to complex surgeries, and its purpose is to stimulate the growth of the patient's cells

Erosive (degenerative) disc disease - DDD is actually a natural process of aging. Erosive disc disease is a collective name for various diseases such as: herniated disc, spinal canal narrowing and other diseases that worsen over the years.

Unfortunately as we age the discs between our vertebrae lose their flexibility and ability to absorb shock. The ligaments that surround the disc become more vulnerable, and part of the disc begins to dry out and shrink. When the degenerative disc disease becomes painful or symptomatic, it can cause a number of symptoms such as: back pain, leg pain and weakness. When the disc causes pressure on the nerve roots, the pain often radiates to the leg or foot and is associated with tingling sensations and decreased sensation.

People who suffer from back pain as a result of mechanical problems, which cause instability of the vertebrae, need immobilization of the vertebrae, because any movement of them causes unbearable pain that severely affects their quality of life and daily functioning. Vertebral fixation surgery is indicated and treated with problems in the spinal canal due to erosive disc disease. Most back pain is caused by problems with the spine itself, the causes are varied and among them, the slipping of the vertebrae, in the discs between the vertebrae, in the nerves that are pressed in the spinal canal and in the soft tissues that surround the spine (muscles and straps).

Patients who do not respond to conservative treatment (physiotherapy drugs, etc.) the option of surgery to fix the spine has become preferred. The above surgery stabilizes the spine by fusing two adjacent vertebrae and thus helps relieve the back pain caused by the worn disc.
In order to enable the fusion of two adjacent vertebrae, the surgeons use a bone graft which is placed in the space between the vertebrae and fills the protrusions of the spine. The surgery is performed through an incision in the back and is usually done in the lumbar spine.

The infusion is a breakthrough innovative technology, which is a biological bone substitute, and is used during spinal fixation surgery. This is a sponge made of collagen tissue and used as a carrier of the BMP protein, which appears as a liquid in the vial. In preparation for surgery, the protein is injected onto the swab, the swab dissolves exclusively in the bone and causes fusion and growth. And its advantage is that it significantly accelerates the rate of bone fusion and causes the growth of bone in a larger amount, in 10%-30% of those operated on, a bridge will not be created between the vertebrae, but a simulated joint that will accompany back pain and the implantation of a biological bone substitute will be particularly effective.

The effectiveness of biological bone substitute implantation is emphasized in smokers who need spinal fixation surgery, studies have shown that nicotine interferes with bone fusion in 30% of them.

Another advantage regarding the implantation of a biological bone substitute, which is produced scientifically and does not require special preparations on the part of the surgeon, or discomfort on the part of the patient, which increases the rate of bone formation and ensures a high percentage of the fusion of the vertebrae.