A porcine collagen-derived matrix as a carrier for recombinant human bone morphogenetic protein-2 enhances spinal fusion in rats

BACKGROUND CONTEXT: Recombinant bone morphogenetic proteins (rhBMPs) have been used successfully in clinical trials. However, large doses of rhBMPs were required to induce adequate bone repair. Collagen sponges (CSs) have failed to allow a more sustained release of rhBMPs. Ongoing research aims to design carriers that allow a more controlled and sustained release of the protein. E-Matrix is a injectable scaffold matrix that may enhance rhBMP activity and stimulate bone regeneration. PURPOSE: The purpose of this study was to test E-Matrix as a carrier for rhBMPs in a CS and examine its feasibility in clinical applications by using a rat spinal fusion model. PATIENT SAMPLE: A total of 80 Lewis rats aged 8-16 weeks were divided into nine groups. STUDY DESIGN/SETTING: Rat spinal fusion model. OUTCOME MEASURES: Radiographs were obtained at 4 6, and 8 weeks. The rats were sacrificed and their spines were explanted and assessed by manual palpation, high-resolution micro-computed tomography (micro-CT), and histologic analysis. METHODS: Group I animals were implanted with CS alone (negative control) Group II animals with CS containing 10 mu g rhBMP-2 (positive control): Group III animals with CS containing 3 mu g rhBMP-2; Group IV animals with CS containing 3 mu g rhBMP-2 and E-Matrix; Group V animals with CS containing 1 mu g rhBMP-2; Group VI animals with CS containing 1 mu g rhBMP-2 and E-Matrix; Group VII animals with CS containing 0.5 mu g rhBMP-2; Group VIII animals with CS containing 0.5 mu g rhBMP-2 and E-Matrix; and Group IX animals with CS and E-Matrix without rhBMP-2. RESULTS: Radiographic evaluation, micro-CT, and manual palpation revealed spinal fusion in all rats in the BMP-2 and E-Matrix groups (IV, VI, and VIII) and high-dose BMP-2 groups (II and III). Four spines in the 3 mu g rhBMP-2 group (V) fused, and one spine in the 0.5 mu g rhBMP-2 group (VII) exhibited fusion. No spines were fused in Groups I (CS alone) and IX (E-Matrix alone). The volume of new bone in the area between the tip of the L4 transverse process and the base of the L5 transverse process in Group IV was equivalent to the volumes observed in Group II. CONCLUSION: E-matrix enhances spinal fusion as a carrier for rhBMP-2 in a rat spinal fusion model. The results of this study suggest that E-Matrix as a growth factor carrier may be applicable to spinal fusion and may improve rhBMP-2's activity at the fusion site. (C) 2009 Elsevier Inc. All rights reserved.