松质骨的异体骨笼填充重建兔第四颈椎缺损

Effect of allogenic cortical ring packed with autogenous cancellous bone in the reconstruction of rabbit cervical vertebra defects

背景:椎体切除后的重建依然是脊柱外科医生面临的难题,理想的重建材料应该具有良好的成骨作用、可靠的支持性能、低廉的价格和简单的操作步骤。目的:观察兔颈椎缺损模型填充自体松质骨的异体骨笼重建的可行性和效果。方法:切除兔第四颈椎体建立颈椎缺损模型,利用免肱骨皮质环经冷冻干燥等处理制备同种异体皮质骨笼,并以填充松质骨的皮质骨笼、自体髂骨和单纯皮质骨笼3种材料分别重建兔第四颈椎椎体缺损。结果与结论:X射线、组织病理学和透射电镜观察均表明,填充有松质骨的皮质骨笼组的成骨作用最明显,骨笼与上下椎体实现了骨性融合。血清碱性磷酸酶检测表明,在重建后2,4周时,填充松质骨的皮质骨笼组和自体髂骨移植组的血清碱性磷酸酶含量差异均无显著性意义,但两组的血清碱性磷酸酶含量均高于单纯异体皮质骨笼组(P<0.01)。生物力学实验表明,填充松质骨的皮质骨笼组在重建后1个月时的稳定性高于自体髂骨移植组(P<0.01)。结果证实,兔颈椎缺损模型填充松质骨的异体骨笼重建后效果满意,强于单纯皮质骨笼和自体髂骨的移植效果,生物相容性良好。

BACKGROUND： Vertebral reconstruction is still a challenge for spinal surgeons. Ideal reconstruction materials should have good osteogenesis ability, reliable support performance, low price and simple operating steps. OBJECTIVE： To investigate the effect and feasibility of allogenic cortical ring packed with autogenous cancellous bone in the reconstruction of rabbit cervical vertebra defect. METHODS： Cervical vertebra defect models were established by resection of the fourth cervical vertebra in rabbits. Frozen-dried humeral cortical ring of rabbits was made to prepare the allogenic cortical ring which was packed with autogenous cancellous bone. Then, allogenic cortical ring packed with autogenous cancellous bone, single all0genic cortical ring and autogenous iliac bone were used to repair rabbit cervical vertebra defects. RESULTS AND CONCLUSION： The X-ray, histopathological examination, and scanning electron microscope examinations all showed that the bone union was most significant in group reconstructed with allogenic cortical ring packed with autogenous cancellous bone. The alkaline phosphates activity in serum was higher in groups reconstructed with allogenic cortical ring packed with autogenous cancellous bone and with autogenous iliac bone than in group reconstructed with only allogenic cortical ring at 2 and 4 weeks after operation （P 〈 0.01）, but there was no difference between the former two groups. The biomechanical examination showed that the stability of allogenic cortical ring packed with autogenous cancellous bone was higher than that of autogenous iliac bone at 1 month after operation （P 〈 0.01）. These findings indicate that the effect of allogenic cortical ring packed with autogenous cancellous bone in the reconstruction of rabbit cervical vertebra defects is satisfactory, with a good biocompatibility, which is a promising method for the reconstruction of vertebral defects.