恒古骨伤愈合剂促进腰椎板开窗术后微小骨粒回植骨重建的实验研究

Experimental study of Osteoking on bone reconstruction after lumbar laminectomy and bone grains replantation surgery

目的探讨恒古骨伤愈合剂促进兔腰椎板开窗处自体微小骨粒骨重建的疗效及作用机制。方法选取清洁级健康雄性新西兰大白兔22只,随机分为3组,治疗组(n=9)、对照组(n=9)、正常组(n=4)。治疗组建立兔腰椎板开窗术后微小骨粒回植的模型,给予恒古骨伤愈合剂治疗(按经由人与兔体表面积用药量换算计算出的剂量,兔用药量为1.30 m L/kg),灌胃,1次/2 d,服用3个月;对照组建立模型后,服用相同剂量的生理盐水,正常组未进行手术处理,相同剂量的生理盐水灌服,治疗后4、8、12周分别行大体标本粘连组织观察、羟脯氨酸(Hyp)测定、CT检查及组织形态学观察。结果大体观察及组织学发现,治疗组的粘连程度Rydell分级及组织学分级要远低于对照组(P<0.05)。羟脯氨酸浓度分析结果显示治疗组瘢痕组织中羟脯氨酸浓度要明显低于对照组(P<0.05)。CT检查示术后12周治疗组微小骨粒形成骨板与开窗椎板骨质相连、骨梁连续,无明显界限,椎管形态及容积无明显变化,未见脊髓受压;对照组对照节段椎板缺损,少量瘢痕突入椎管内,椎管重建未完成。结论恒古骨伤愈合剂可有效促进兔椎板开窗处再植自体微小骨粒的骨重建,形成的骨板可遮挡瘢痕侵入椎管,减少椎管内粘连。

Objective To explore the therapeutic effect and mechanism of Osteoking on bone reconstruction by observing the experimental research of Osteoking on bone reconstruction after lumbar laminectomy and bone grains replantation surgery in rabbits. Methods 22 healthy male New Zealand rabbits were selected and randomly divided into 3 groups, treatment group （n = 9）, model group （n = 9） and normal group （rr = 4）. Treatment group and model group were performed with lumbar laminectomy and bone grains replantation surgery. Osteoking was offered to treatment group and normal saline （NS） at the same dose was offered to model group after modeling （according to the surface area of human to rabbits, the rabbits were treated with 1.30 mL/kg, 1 time/2 d, 3 months）. No surgery procedure was offered to normal group but same dose of NS. Observation of adhered tissue and morphological changes, determination of hydroxyproline （Hyp） as well as CT scan were performed after 4, 8 and 12 weeks＂ treatment. Results Though the gross observation and histological observation, the results of treatment group which Rydell and organization classification were far lower than those of model group （P 〈 0.05）. Expression of Hyp showed that the treatment group had the lower epidural adhesion compared with the normal group （P 〈 0.05）. After 12 weeks of surgery, CT examination showed the bone plate which formed by bone grain in treatment group was connected with the vertebral bone, which canal morphology and volume had no obvious change, and no spinal cord compression; model group showed segment lamina defect which a small scar protruded into the spinal canal, and the vertebral canal reconstruction was not complete. Conclusion Osteoking can ef- fectively promote bone reconstruction in the lamina of rabbits, and the bone plate can prevent scar from expanding into the spinal canal, and can reduce the intraspinal conglutination.