The process of building, healing and remodeling bone in humans is called osteoinduction. In the 1960s orthopaedic investigators discovered a family of substances in human blood and bones that stimulates the process of osteoinduction, they called these substances bone morphogenetic proteins, or BMP. In the past 15 years, investigators have found a way to isolate and extract these substances from natural tissues, as well as produce them in laboratories. BMPs have been used to stimulate the production of bone in animals and humans.
In spine surgery, especially during spinal fusions, surgeons may opt to use transplanted bone grafts to aid in the healing and remodeling of the spine after surgery. The use of bone grafts can add increased postoperative pain, if the bone is transplanted from one area of the patient's body to another (called autograft), or a chance of disease transmission if the bone is transplanted from one person to another (called allograft). Spine surgeons hope the use of BMP and rhBMP (BMP that is produced in a laboratory) may, in the future aid them in generating and repairing bone without the drawbacks of grafts.
Although the Food and Drug Administration has not fully approved the use of BMPs, many clinical trials have found the substance to be effective in generating bone in the spine. Current research is also focusing on the most effective method of introducing the substance into the spine, such as collagen sponges in fusion cages or in a collagen putty. The research is ongoing and the spine community is encouraged by BMPs and hopes they may someday reduce postsurgical pain and improve the effectiveness of spinal surgeries.
