The effect of fibrin adhesive (Tisseel) on interbody allograft fusion: An experimental study with cats

Fibrin glue has been promoted for use in many neuro- and orthopaedic surgic al procedures. At present, some surgeons make routine use of the adhesive i n augmentation of bone grafting operations. However, there is controversy a bout its effectiveness in augmenting bone graft healing. This study investi gated the use of two-component fibrin sealant (Tisseel(R), Immune AG, Vienn a, Austria) as an adjunct to graft material in fusion surgery. Twenty-four cats were fused with corticocancellous bone graft, which was taken from a s eparate cat, across the disc space in the anterior cervical region. In the present experiment, the authors carried out cervical interbody fusio ns in 24 cats, divided into two groups, to test the usefulness of fibrin gl ue in fixation of allograft fusions. At surgery, a piece of corticocancello us allograft was placed into the intervertebral disc space at the Cs-Cs reg ion, either untreated or locally treated with fibrin adhesive (Tisseel). Fu sion mass formation was examined 6 months after the experimental fusion pro cedure by radiography and computed tomography (CT) scanning and the new bon e formed was evaluated histologically. The authors observed that the allogr aft fusion mass area is more voluminous in the untreated animals in Group I than in the ones augmented with Tisseel, as illustrated by CT measurement (section area and bone density) (p = 0.038). Accordingly, histopathological studies demonstrated a reduced vascularization of the graft as well as dim inished new bone formation in the animals treated with Tisseel in Group II. The present investigation demonstrates that local fibrin sealing significan tly retards the osteogenic fusion in a model of corticocancellous bone graf ting in cats. In view of our results it seems that fibrin sealant is not su itable for fixation of bone fragments in anterior cervical fusion.