How to accelerate recovery from spine treatments and bone healing

Khai Lam has provided another update for anyone with spine problems, it is all about how fast bone can be made to heal following fractures.Yesterday, London spine expert Mr Khai Lam brought an important new development in latest spine surgical techniques to our attention. According to this article the diameter of the nanotube will determine the subsequent differentiation from stem cells to new bone forming cells (oseoblasts). This combined with the tensile strength of titanium means that we could be getting close to being able to build a whole new spine. Other new developments  are already available for the use of surgeons and their patients. Mr Lam has provided another update for anyone with spine problems, it is all about how fast bone can be made to heal following fractures.

Bone healing following fractures and for that matter, following spinal fusion that is used to treat low back pain from disc degeneration, involves a complex interplay of local biological and biomechanical factors that help stimulate bone formation. Currently donor bone is harvested from the pelvis (hip bone) for spinal fusion but this method can cause pain locally with delay in mobilisation, extra bleeding, prolonged surgical time, local infection and the quality of the bone harvested remains inconsistent. At best, the fusion rates are also suboptimal and quoted to be approximately 70 - 80 %. This protracted healing process takes some 4 to 6 months to produce bone that is sufficiently strong enough to withstand daily weight-bearing loads and up to 9 months for the remodelling process to occur before normal bone is achieved.

The technique described at USCD is impressive but clearly is in its infancy. At present, only a few surgeons like myself routinely use BMPs (bone morphogenic proteins, notably recombinant BMP-2 or r-BMP-2) to accelerate spinal fusion as this method has been demonstrated to produce near 100% fusion rates at 3 months, albeit at a price. But I would consider this money well spent especially if a near 100% fusion rate is achieved and of course, this is less of a concern if the costs are reimbursed by the patient's insurance company. BMP used for spinal fusion has been shown in many clinical studies to greatly improve the quality and quantity of the spinal fusion and with that, associated greatly improved clinical results, i.e. much reduced low back pain.

Therefore, any biological methods that accelerate the fusion process, such as the one described, remains highly desirable as this allows patients to mobilise and rehabilitate quicker, associated with no harvest donor bone graft site problems and an early return back to work and activities, including sports. The indirect effects of this would be greatly improved psychological and economic societal costs. I look forward to hearing about this new technology for its use in bone healing in humans.

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