Experimental Comparison of Autograft and DBM Flex (Grafton) for Spinal Lumbar Fusion in Rabbits

Abstract

Aim: The choice of graft materials used for spinal fusion possesses a great importance due to their crucial roles in bone remodelling. Although autogenous bone grafts are the "gold standard" for spinal fusion surgeries, they can cause various complications. Aim of this study was to compare the efficacy of demineralized bone matrix (DBM) and autograft in lumbar spinal fusion in a rabbit model of spinal lumbar fusion (SLF). Methods: Twenty New Zealand rabbits were randomly divided into two groups and underwent SLF by using either iliac crest autologous bone graft (Autograft, n=10) or DBM Flex (Grafton, n=10). Eight-weeks after surgery, animals were sacrificed and spinal fusion was evaluated by computerized tomography (CT), manual palpation, macroscopic analyses, and histological assessments. Results: CT results revealed that autograft led to significantly higher fusion scores than DBM Flex (p=0.0004). Mobility was significantly lower in autograft group (p=0.0007). Significantly lower bone formation scores were observed in DBM Flex group compared to autograft group (p<0.0001). Histology of spine in the autograft group was significantly better than DBM Flex group (p=0.0002). Conclusion: Autograft was superior than DBM flex in SLF and these results indicate that autograft will continue to be the "gold standard" in SLF in the future.