种植骨髓干细胞的多孔人工骨在猴脊柱后外侧融合术中的应用

β-tricalcium Phosphate Seeded with Bone Marrow Mesenchymal Stem Cells as Bone Graft Substitute for Posterolateral Spinal Fusion

目的使用种植有骨髓间充质干细胞的多孔人工骨应用于动物的脊柱后外侧融合手术,评估组织工程骨能否替代自体骨的使用。方法 6只食蟹猴行双侧L4-5脊柱融合手术。分为3组,分别移植种植细胞的β-磷酸三钙(β-TCP)、自体骨和单纯β-TCP。手术后12周处死。采用手法触压检查、微CT和外周定量CT(pQCT)以及组织学方法进行评估。结果手触检查显示,4例中有3例移植组织工程骨和自体骨形成硬性融合,而移植单纯β-TCP组均无硬性融合形成。组织学分析显示,移植组织工程骨组存在大量骨形成。pQCT显示,组织工程骨新骨形成增加了骨密度。结论组织工程骨可以用于替代自体骨的使用。

Objective To evaluate whether β-tricalcium phosphate （β-TCP） combined with bone marrow mesenchymal stem cells （BMSCs） can be used for lumbar posterolateral spine fusion （PLF） instead of autogenous bone graft.Methods 6 crab-eating macaques underwent bilateral PLF at L4-5,and divided into 3 groups that implanted β-TCP/BMSCs composite,autogenous bone,and β-TCP.Monkeys were sacrificed 12 weeks after implantation.Manual palpation,micro computed tomography,peripheral quantitative computed tomography （pQCT）,and histology were used to assess bone formation.Results Manual palpation showed that 75% of β-TCP/BMSCs composite group and autogenous group achieved solid spine fusion,whereas none of β-TCP group fused.Histological analysis showed that all of the β-TCP/BMSCs group achieved massive bone formation.Bone mineral density （BMD） evaluated with pQCT in the β-TCP/BMSCs group increased by additional new bone.Conclusion β-TCP/BMSCs composite can be used for PLF instead of autogenous bone graft.