Lumbar posterolateral fusion using heparin-conjugated fibrin for sustained delivery of bone morphogenic protein-2 in a rabbit model

We had devised a heparin-conjugated fibrin (HCF) system to deliver bone morphogenic proteins (BMPs) for a long-term period to enhance bone regeneration. In the present study, we tested the effectiveness of the delivery system for spinal fusion in a rabbit model. A total of 15 rabbits underwent posterolateral lumbar spine fusion with BMP-2 (50 μg per collagen sponge). The control group received only collagen sponges without BMP-2, another group (short-term delivery SD] group) received collagen sponges filled with fibrin gel loaded with BMP-2, and the third group (long-term delivery LD] group) received collagen sponges filled with HCF loaded with BMP-2. All animals were euthanized 8 weeks after surgery, and the fusion was assessed by radiographs, manual palpation, computed tomography, and mechanical testing. The fusion rate was significantly higher in the LD group using HCF than in the SD group or in the control group. Biomechanical testing showed the tensile strength was also significantly higher in the LD group using HCF than in other groups. The HCF system can provide a good option for the delivery of BMP-2 on posterolateral lumbar spine fusion.