An effective delivery vehicle of demineralized bone matrix incorporated with engineered collagen-binding human bone morphogenetic protein-2 to accelerate spinal fusion at low dose.

The aim of this study was to investigate the feasibility and efficacy of a new delivery matrix using demineralized bone matrix (DBM) incorporated with collagen-binding bone morphogenetic protein-2 (CBD-BMP-2) in the rat inter-transverse spinal fusion model. Sixty rats undergoing posterolateral (inter-transverse) spinal fusion were divided into 3 groups according to the fusion materials containing different components (n = 20 per group). Group A were implanted with DBM, Group B with combination of DBM and BMP-2 and Group C with combination of DBM and CBD-BMP-2. After surgery, the spinal fusion of all the rats was assessed by plain radiography, CT + 3D reconstruction, manual palpation and histological evaluation. Significant difference was found in terms of solid fusion rate among the three groups, with 95% in Group C, 65% in Group B and 0% in Group A (P < 0.001). Compared with Groups B and A, new bone formation was observed earlier and was obvious larger, trabecular bone microarchitecture assessment was better and bone mineral density was statistically larger in Group C. In addition, more newly woven bone and osteocytes were shown by histological evaluation in Group C at 4 weeks post-operation. The present study showed CBD domain could help BMP-2 to improve the efficiency of posterolateral spinal fusion. DBM scaffold activated by collagen-binding BMP-2 was a feasible and promising bone repair vehicle. The present study showed better results in terms of plain radiography, CT + 3D reconstruction, manual palpation and histological evaluation in the rat inter-transverse spinal fusion model using DBM+CBD-BMP-2, compared with DBM+BMP-2 and DBM alone, indicating DBM scaffold activated by collagen-binding BMP-2 was a feasible and promising bone repair vehicle.