Demineralized bone matrix combined with concentrated growth factors promotes intervertebral fusion in a novel rat extreme lateral interbody fusion model.

Abstract

Background: Whether demineralized bone matrix (DBM) combined with concentrated growth factors (CGF) can accelerate intervertebral fusion remains uncertain. This study developed a novel rat model for extreme lateral interbody fusion (XLIF) and evaluated the fusion outcomes of DBM combined with CGF using imaging and histological analysis.

Methods: A total of 70 male SD rats (3 months old, average body weight 300 ± 50 g) were included in this study. Among them, 10 rats were used for the anatomical study of the lumbar spine. The remaining 48 rats were randomly divided into four groups (n = 12 per group): Group A (control), Group B (titanium plate fixation), Group C (DBM + titanium plate fixation), and Group D (DBM + CGF + titanium plate fixation). The remaining 12 rats were used as donors to prepare fresh CGF. Eight weeks after surgery, the rats were euthanized and lumbar spine specimens were collected, with interbody fusion evaluated by manual palpation. Subsequently, specimens from groups B, C, and D were analyzed by micro-CT and histological examinations to comprehensively assess the fusion outcome.

Results: The anatomical and surgical techniques for the rat XLIF model are described. Titanium plates (7 mm × 2.5 mm × 0.8 mm) and screws (3 mm × 1 mm) were designed based on the anatomical measurements. In Group A, spontaneous fusion occurred in 1 case; the remaining 11 cases showed intervertebral mobility. In Group B, 3 cases achieved fusion; in Group C, 8 cases; and in Group D, 11 cases. Micro-CT revealed fusion index scores (FIS) of 2.21 ± 0.51 for Group B, 3.62 ± 0.67 for Group C, and 4.57 ± 0.56 for Group D. Histological examination showed limited bone formation in Group B, with fibrous connective tissue filling the intervertebral space. Group C showed more bone formation, but some cartilage and fibrous tissue remained. Group D demonstrated abundant new bone formation and robust histological fusion, with substantial bridging between vertebrae.

Conclusion: The rat XLIF model for interbody fusion has been successfully established and validated. Using this model, it was preliminarily demonstrated that DBM combined with CGF can effectively promote intervertebral fusion in rats.