脊柱横突间融合治疗中异种脱蛋白松质骨应用的可行性探讨

Feasibility study on the application of the heterogeneous de protein cancellous bone in the treatment of lumber lntertransverse process spinal fusion

目的探讨脊柱横突间融合治疗中应用异种脱蛋白松质骨的可行性。方法选取6—8月龄健康雄性青山羊30只，制备横突间植骨床，按随机数字表法分为I组和Ⅱ组，每组15只。I组于左侧植入组织工程骨（A组），右侧植入重组人骨形态发生蛋白-2（rhBMP-2）复合骨（B组），Ⅱ组于左侧植入自体骨（c组），右侧植入单纯异种脱蛋白松质骨（D组），观察各组X线、组织学形态以及最大弯曲载荷。结果（DB组和D组术后4、8、12周x线评分均低于C组（P〈0．05）；A组术后4、8、12周X线评分分别为（5．30±0．41）分、（8．54±0．89）分和（11．25±0．91）分，与C组各期比较差异无统计学意义（P〉0．05）。（2）A组、B组和D组术后4、8周组织学评分均低于C组（P〈0．05）；A组术后4、8周组织学评分高于B组和D组（P〈0．05）；B组和D组术后12周组织学评分低于c组（p〈0．05）；A组术后12周组织学评分为（11．04±1．52）分，与C组比较差异无统计学意义（P〉0．05）。（3）B组和D组最大弯曲载荷低于C组（P〈0．05）；A组最大弯曲载荷为（60．32±10．10）N，与C组比较差异无统计学意义（P〉0．05）。结论异种脱蛋白松质骨为载体构建组织工程骨成骨性能接近自体骨，但单纯异种脱蛋白松质骨成骨差。

Objective To investigate application feasibility of the heterogeneous de protein cancellous bone in the treatment of lumber intertransverse process spinal fusion. Methods Thirty 6-8 month healthy male goats were selected to make intertransverse bone bed, and were randomly divided into groups Ⅰ and Ⅱ, with 15 in each group. Group I was the left side implanted the tissue engineering bone （A group）, and the right side implanted recombinant human bone morphogenetic protein-2 （rhBMP-2） com- posite bone （ B group） ; Group Ⅱ was the left implanted autologous bone （ C group）, and the right side implanted simple heterogeneous de protein cancellous bone （D group）. Each groUp was observed with the X- ray, histological morphology, and maximum bending load. Results （1） In groups B and D, postoperative 4-, 8- and 12-week X-ray scores were lower than that of group C （ P 〈 0.05 ） ; In group A, postoperative 4-, 8- and 12-week X-ray score were （ 5.30±0.41 ） points, （ 8. 54 4- 0. 89 ） points, and （ 11.25±0. 91 ） points, compared to group C, without statistically significant difference （P 〉 0. 05） ; （2） For groups A, B and D, postoperative 4- and 8-week histological scores were significantly lower than those in group C （P 〈 O. 05）. For group A, postoperative 4- and 8-week histological scores were significantly higher than those of groups B and D （P 〈0. 05）. The histological scores of groups B and D postoperative 12 weeks were lower than those of group C （P 〈0. 05）. The histological score of group A postoperative 12 weeks was （11.04±1.52） points, compared to group C without statistically significant difference （ P 〉 0. 05 ） ; （3） The maximum bending load of groups B and D was lower than that of group C （P 〈 0. 05 ）. The maximum bending load of group A was （60. 32±10. 10） N, compared to group C without statistically significant difference （ P 〉 0.05）. Conclusions The construction of tissue engineered bone by the heterogeneous de protein Cancellous bone, its osteogenesis is close to autogenous bone, but simple heterogeneous de protein cancellous bone osteogenesis is poor.