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Medical Breakthroughs: Spinal Putty

BACKGROUND: About 258,000 people have spinal fusion surgery each year. About 119,000 of the procedures involve the upper (cervical) spine, and about 139,000 involve the lower (lumbar) spine.

Spinal fusion is essentially a procedure where two or more of the vertebrae are "welded" together. This is generally done using donor bone, which comes from either the patient's hip or a cadaver. Screws and titanium cages are also used to help the vertebrae fuse together.

The procedure is usually done to treat injuries to the spine, protrusion and degeneration of the disc between vertebrae, abnormal curvatures, and weak or unstable spine caused by infections or tumors. The procedure results in reduced movement in the spine and a long healing process both in the area of the back that was treated as well as the hip from where the bone was taken.

There is also a risk of nerve damage or infection from the hardware that is implanted. Another disadvantage of the screws is that they can interfere with the physician's ability to image the spine.

NO MORE SCREWS OR BONE: Orthopedic surgeons and neurosurgeons around the United States are studying a new procedure that may do away with the need for the bone graft and the screws. They are studying a substance called bone morphogenetic protein, or BMP. BMP is a naturally occurring protein in the body that is used as one step in the formation of bone.

Researchers believe a synthetic form of BMP can help improve spinal fusion surgery. The protein comes to surgeons as a dry powder. It is mixed with a carrier in the operating room and forms a putty. The putty can then be molded into any shape and placed on the surgical site between the vertebrae that are to be fused.

During the healing process, the BMP aids in the production of new bone and the vertebrae become fused.

FUTURE USES: Carl Lauryssen, M.D., of Washington University School of Medicine in St. Louis, says in the future it could be that BMP is used to strengthen the bones of people with osteoporotic compression fractures. He says it may also be helpful for people who been treated with steroids for other conditions and have weakened bones.

STUDY: The goal of the study, which is taking place at 21 centers around the United States, is to see how the BMP compares to traditional surgery with bone from the hip and screws. Patients will be treated with either putty or bone grafts, no screws will be used in the study. Clinical outcomes will be analyzed and compared.

FOR MORE INFORMATION, PLEASE CONTACT:

Marc Pudlowski, R.N.
Research Coordinator
Washington University School of Medicine
Box 8009, 660 South Euclid Avenue
St. Louis, MO 63110
(314) 747-0994
pudlowsm@msnotes.wustl.edu


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