OSTEOAMP Lumbar Fusion Intra-Patient Controlled Study

Inclusion Criteria:

• Skeletally mature male or female patient, at least 21 years of age and no more than 80years of age, inclusive, at the time of surgery;
• Has symptomatic degenerative disc disease (DDD) of the lumbosacral spine in two levels (L2 to S1). Lumbar DDD is defined as discogenic back pain with or without radicularsymptoms confirmed by patient history and radiographic studies
• Has radiographic evidence (e.g. CT, MRI, x-ray, etc.) of degenerative lumbosacraldisease including instability up to and including Grade 1 spondylolisthesis at theinvolved level(s)
• Requires fusion (i.e., symptomatic) at 2 adjacent or non-adjacent levels from L2 toS1;
• Non-responsive to non-operative treatment (e.g., bed rest, physical therapy,medication,spinal injection, manipulation, and/or TENS) for at least 6 months;
• Willing and able to comply with the study protocol (including post-operative clinicaland radiographic evaluations and required rehabilitation plan) and able to understandand sign the Informed Consent.

Exclusion Criteria:

• Previous lumbar spine surgery with the exception of discectomy and/or laminectomy atthe target levels.
• Lumbar scoliosis >30 degrees.
• Documented history of osteoporosis, osteomalacia, Paget's disease or metabolic bonedisease
• Morbidly obese, as defined by a Body Mass Index (BMI) >40 kg/m2.
• Documented history of uncontrolled diabetes mellitus
• Presence of active malignancy or prior history of malignancy (non-invasive basal cellcarcinoma of the skin is allowed).
• Overt or active bacterial infection, either local to surgical space or systemic.
• Chronic use of steroids (defined as more than 6 weeks of steroid use within 12 monthsof surgery, other than episodic use or inhaled corticosteroids)
• Co-morbidities, which in the investigator's opinion, precludes the subject from beinga surgical candidate.
• Autoimmune disease, which in the investigator's opinion, is known to affect bonemetabolism or the spine (e.g., spondyloarthropathies, juvenile arthritis, rheumatoidarthritis, Graves' disease, Hashimoto's thyroiditis).
• Any endocrine or metabolic disorder, which in the investigator's opinion, is known toaffect osteogenesis (e.g., Paget's disease, renal osteodystrophy, Ehlers- Danlossyndrome, or osteogenesis imperfecta).
• History of hypersensitivity and/or allergy to any of the agents used to processOSTEOAMP SELECT, including bacitracin, polymyxin B sulfate, and gentamicin.
• Known hypersensitivity or allergy to any components of the study treatments including,but not limited to bone morphogenetic proteins (BMPs); injectable collagen; proteinpharmaceuticals (e.g., monoclonal antibodies or gamma globulins); bovine collagenproducts; and/or instrumentation materials (e.g., titanium, titanium alloy, cobaltchrome,cobalt chrome alloy, or PEEK).
• Is a prisoner.
• Treatment with an investigational therapy (drug, device, and/or biologic) targetingspinal conditions within 3 months prior to implantation surgery, treatment with anyother investigational therapies within 30 days prior to implantation surgery, or suchtreatment is planned during the 24-month period following implantation of the studytreatment.
• Pregnant or nursing. Females of child-bearing potential must agree not to becomepregnant for the duration of the study.
• A history of alcohol and/or drug abuse within 6 months prior to screening or exhibitsevidence, in the investigator's opinion, of alcohol/drug abuse at screening.
• Current history of heavy nicotine use (e.g. more than 20 cigarettes per day).
• Any condition, which in the investigator's opinion, would interfere with the subject'sability to comply with study instructions, which might confound data interpretation.