重组人骨形态发生蛋白2/丝素蛋白缓释微球增强型多孔双相磷酸钙人工骨用于绵羊腰椎椎体间的融合

Lumbar interbody fusion with porous biphasic calcium phosphate enhanced by recombinant human bone morphogenetic protein-2/silk fibroin sustained-release microsphere in a sheep model

背景:作者既往已研究重组人骨形态发生蛋白2/丝素蛋白缓释微球增强型多孔双相磷酸钙的孔隙率、孔径、机械强度、体外生物活性、异位成骨活性等,需要通过建立可靠的动物模型来验证其生物安全性和可行性,并对复合材料的成骨能力进一步评估,为该骨移植材料用于脊柱融合提供进一步的实验数据。目的:在绵羊腰椎间融合模型中验证重组人骨形态发生蛋白2/丝素蛋白缓释微球增强型多孔双相磷酸钙的成骨效果,探讨其应用于椎体间融合的可能性。方法:将16只健康的成年绵羊建立L1/2、L3/4和L5/6的椎体间融合模型,每只动物的L1/2、L3/4和L5/6中随机植入自体髂骨、重组人骨形态发生蛋白2/丝素蛋白缓释微球增强型多孔双相磷酸钙、重组人骨形态发生蛋白2缓释微球增强型多孔双相磷酸钙、重组人骨形态发生蛋白2/丝素蛋白缓释微球中的3种。结果与结论:植入后12周和24周新型人工骨重组人骨形态发生蛋白2/丝素蛋白缓释微球增强型多孔双相磷酸钙的融合率与自体髂骨类似,均明显优于其他组。结果说明重组人骨形态发生蛋白2/丝素蛋白缓释微球增强型多孔双相磷酸钙人工骨能够在模型动物体内获得了与自体髂骨相似的腰椎融合效果,通过对其性能的进一步改良与验证可望运用于医学实践。

BACKGROUND： The authors have studied the porosity, pore size, mechanical strength, in vitro biological activity,ectopic osteogenic activity of porous biphasic calcium phosphate enhanced by recombinant bone morphogenetic protein-2/silk fibroin sustained-release microsphere （BCP/rBMP-2/SF）. However, further investigation on the osteogenic ability of the composite bone graft material is warranted based on a reliable animal model, which will provide experimental data for the clinical application of the composite material in the spinal fusion.OBJECTIVE： To investigate the osteogenic efficacy of BCP/rBMP-2/SF in a sheep lumbar interbody fusion model.METHODS： Sixteen healthy adult sheep were divided into two groups randomly. All sheep were operated on the left extraperitoneal approach and intervertebral discs of L1/2, L3/4, and L5/6 were exposed respectively. Three of the following four materials were randomly implanted into the L1/2, L3/4, and L5/6 of each animal： autologous iliac, BCP/rhBMP-2/SF,BCP/rhBMP-2 or BCP/SF.RESULTS AND CONCLUSION： The group of BCP/SF/rhBMP-2 achieved a similar fusion rate compared with the group of autologous iliac at 12 and 24 weeks after operation, and they were significantly better than the other two groups. These findings indicate that the novel new artificial bone, BCP/rhBMP-2/SF, can obtain similar lumbar fusion results compared with the autologous iliac. It is expected to be applied to clinical practice in the future by further improving its properties.