Liofilizado de fibrina combinado con injerto óseo autólogo en artrodesis posterolateral. Estudio en conejos de Nueva Zelanda

Summary Background: Currently there are different strategies to in- crease the fusion rate in spine surgery in the presence of au- tologous bone graft. The use of fibrin glue has multiple appli- cations in surgery, but there is controversy about the use of fibrin glue as a bone enhancer. Methods: The purpose of the study was to determinate the effectiveness of fibrin glue as a bone enhancer in posterolat- eral arthrodesis in New Zealand rabbits. Posterolateral arthro- desis was done in ten New Zealand rabbits at the level of L5- L6 using autologous bone graft in the right side (control side) and autologous bone graft plus fibrin glue in the left side (study side). The rabbits were harvested at 8 weeks, obtaining the lumbar spine for radiological, manual palpation and light mi- croscopic analysis. Results: Solid arthrodesis was obtained in 100 % of the con- trols and in only 60 % of the study animals. There were no dif- ferences among methods for determination of solid arthrodesis whether by radiological, manual palpation or light microscopic analysis. In 40 % of non-unions, only in one (10 %) was fibrocar- tilage obtained. In the remaining 30 %, only inflammatory cells were obtained in the gap between the transverse process. Conclusions: Fibrin glue does not have a positive effect in the success of solid fusion in posterolateral arthrodesis in rab- bits. The use of fibrin glue significantly decreased the rate of solid fusion; therefore, we do not recommend its use as a bone enhancer.