Efficacy of Interspinous Process Fusion with Recombinant Human Bone Morphogenetic Protein-2 Delivered by a Synthetic Polymer and β-Tricalcium Phosphate

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Regular spinal interbody fusion and posterolateral fusion involve the use of large incisions, dissection, and partial transection of the paravertebral muscle to expose the posterior spine. On the other hand, the approach to perform an interspinous process fusion involves only muscular stripping and preserves almost all structural components of the spine. If interspinous process fusion by use of Bone morphogenetic proteins (BMPs) is successfully achieved, it could reduce the axial compressive load on the vertebral column. This method would be one of the less morbid surgical options for treatment of lumbar disorders. In this study, we attempted to achieve an interspinous process fusion and evaluate its efficacy in experimental rabbit models by using a delivery system for recombinant human (rh) BMP-2. We achieved solid interspinous process fusion in experimental rabbit models by implanting a biodegradable bone-inducing implant composed of 60μg of rhBMP-2 within a period of 8 weeks. The efficacy of the interspinous process fusion was indicated by the stabilization of the spinal column and decrease in the intradiscal pressure due to axial compressive loading.