ViBone in Cervical and Lumbar Spine Fusion

This study is a prospective, multi-center study to evaluate the clinical and radiographic
outcomes of ViBone in patients undergoing ACDF or lumbar interbody fusion. Data will be
gathered for a minimum of 25 subjects undergoing ACDF surgery and a minimum of 100 subjects
undergoing lumbar fusion surgery using ViBone. Total enrollment is expected to be
approximately 200 subjects. The purpose of this study is to assess clinical and radiographic
outcomes in patients who undergo 1-3 level ACDF or lumbar interbody fusion surgery using
ViBone. Subjects will be followed for 12 months following surgery.

Inclusion Criteria:

- Male or female, 18-80 years of age

- For cervical cases - ACDF surgery at 1, 2, or 3 contiguous levels between C2-C7

- For lumbar cases - lumbar interbody fusion surgery at 1, 2, or 3 contiguous levels
between L1-S1

- Patient signed Consent Form with HIPAA Authorization

- Appropriate candidate for surgery

- Patient will adhere to the scheduled follow-up visits and requirements of the protocol
including routine patient exams - pre-operative, operative, and at least two post-
operative visits (6 and 12 months post-surgery). Pre-operative and post-operative
visits include X-ray (required) and CT scan (if available).

Exclusion Criteria:

- Long term use of medications that are known to inhibit fusion or bone metabolism or
immune suppressants 6 months prior to surgery (i.e., steroids, chemotherapy, DMARDs,
etc.)

- Treatment with radiotherapy

- Acute or chronic systemic or localized spinal infections

- Instability associated with major reconstructive surgery for primary tumors or
metastatic malignant tumors of the cervical (for ACDF patients) or lumbar (for TLIF,
PLIF, ALIF, or LLIF patients) spine

- Previous pseudoarthrosis at any level of the cervical (for ACDF patients) or lumbar
(for

- TLIF, PLIF, ALIF, or LLIF patients) spine

- Nursing mothers or women who are pregnant or plan to become pregnant during the course
of the study

- Current or recent history of malignancy or infectious disease. Patients with current
or recent history of basal cell carcinoma are eligible.

- Inability to provide informed consent

- Rapid joint disease, bone absorption, osteomalacia, and/or diagnosed osteoporosis
(bone density score of ≤-2.5).

- Other medical or surgical conditions which would preclude the potential benefit of
surgery, such as congenital abnormalities, immunosuppressive disease, elevation of
sedimentation rate unexplained by other diseases, elevation of white blood count
(WBC), or marked left shift in the WBC differential count.

- Active local or systemic infection or is undergoing adjunctive treatment for local or
systemic infection.