不同植骨融合材料在腰椎椎体间脊柱融合中的应用

Different bone graft fusion materials applied in lumbar interbody fusion

背景:脊柱融合治疗时选择合适的替代移植骨具有重要的意义,能够解决自体骨移植及其他移植材料带来的弊端。目的:观察不同植骨融合材料性能,探讨不同植骨融合材料在犬腰椎椎体间脊柱融合中的应用效果。方法:选取45只中华田园犬建立腰椎椎体间脊柱融合模型,建模后随机分3组,分别植入自体髂骨、重组人骨形态发生蛋白2复合材料和同种异体髂骨,分析不同植骨融合材料在犬腰椎椎体间脊柱融合中的效果。结果与结论:(1)融合率:重组人骨形态发生蛋白2复合材料组犬融合率显著高于其他组(P<0.05);(2)Oswestry功能障碍指数:重组人骨形态发生蛋白2复合材料组术后Oswestry功能障碍指数显著低于其他2组(P<0.05);(2)组织学形态:苏木精-伊红染色显示,术后12周,与其他2组相比,重组人骨形态发生蛋白2犬完全骨性融合,且形成了连续骨小梁,植入骨与犬上下椎体完全粘连;(4)结果提示:重组人骨形态发生蛋白2复合材料更能够促更好地促进脊柱愈合,效果优于自体和同种异体骨移植。

BACKGROUND： The choice of suitable bone graft substitute is vital for spinal fusion treatment, which can solve some limitations caused by autogenous bone graft and other materials. OBJECTIVE： To investigate properties of different bone graft fusion materials, and to explore their application in dog spinal fusion of lumbar vertebral body. METHODS： Forty-five Chinese rural dogs were enrol ed to prepare lumbar interbody fusion models, and then were randomized into three groups transplanted with autogenous ilium, recombinant human bone morphogenetic protein-2 composite or al ograft ilium, respectively. Afterwards, effects of different materials in the lumbar interbody fusion were analyzed. RESULTS AND CONCLUSION： The fusion rate of the composite group was significantly higher than those of the other groups （P 〈 0.05）. Oswestry dysfunction index of the composite group was significantly lower than those of the other groups after surgery （P 〈 0.05）. Hematoxylin-eosin staining showed that dogs achieved complete bony fusion, continuous bone trabecula gradual y formed, and there was no gap between the transplanted bone and the bone surface in the composite group compared with the other groups at 12 weeks after surgery. These results demonstrate that recombinant human bone morphogenetic protein-2 composites can significantly promote the spinal fusion superior to autologous and al ogeneic bone grafts.