Engineered collagen-binding bone morphogenetic protein-2 incorporated with platelet-rich plasma accelerates lumbar fusion in aged rats with osteopenia

Abstract

In aged individuals, osteopenia is a great concern for achieving solid spinal fusion. Spinal malunion could lead to various implant-related complications and reduce postoperative quality of life. This study aims to investigate the efficacy of collagen-binding bone morphogenetic protein-2 (CBD-BMP-2) on the treatment of lumbar inter-transverse defects and to explore whether platelet-rich plasma could help CBD-BMP-2 to achieve a better outcome in terms of osteogenesis in senile rats with osteopenia. In vitro experiment proved the angiogenic function of platelet-rich plasma and osteogenic effect of CBD-BMP-2. Rats were performed posterolateral lumbar inter-transverse fusion. Rats implanted with CBD-BMP-2 + platelet-rich plasma were assigned to Group A ( n = 20), rats implanted with CBD-BMP-2 were assigned to Group B ( n = 20), and those with platelet-rich plasma were assigned to Group C ( n = 20). Four weeks after implantation, radiographic assessment, manual palpation, and histological evaluation were performed. In vivo experiments showed satisfactory therapeutic effect on lumbar inter-transverse fusion in both Groups A and B and better results of bone microarchitecture in Group A. Solid fusion rate was 77.8% in Group A, 66.7% in Group B, and 0% in Group C ( P < 0.001). Our study indicated that CBD-BMP-2 could effectively facilitate the lumbar inter-transverse fusion in aged rats with osteopenia and platelet-rich plasma could help CBD-BMP-2 to enhance the bone healing of vertebral defects.

Transforaminal Endoscopic Lumbar Discectomy with versus without Platelet-Rich Plasma Injection for Lumbar Disc Herniation: A Prospective Cohort Study

“…Platelet-rich plasma (PRP) application in treating degenerative disc disease and AF repair in in vitro or animal experiments has yielded promising results [ 9 , 10 ]. As an autologous derivative of whole blood containing a supraphysiological concentration of platelets, PRP can deliver biomolecules to the target injured tissue by modulating inflammatory processes, thereby promoting healing and repair [ 11 ].…”

Application of platelet-rich plasma in spinal surgery

“…To this end, researchers have combined collagen-binding bone morphogenetic protein-2 (CBD-BMP-2), which has good biological activity and slow-release function, with PRP to treat osteopenia in an elderly rat model. Through comparative analysis, the fusion rate, area, volume, and number of bone trabeculae were significantly better than those of the control group; however, PRP alone did not show satisfactory fusion efficiency ( 100 ). This finding is similar to that of a meta-analysis of clinical cases ( 101 ).…”