中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (25): 3693-3698.doi: 10.3969/j.issn.2095-4344.2016.25.007

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

不同植骨融合材料在腰椎椎体间脊柱融合中的应用

覃建朴，王 翀，张朋云，曹广如，蔡玉强，廖文波   

  1. 遵义医学院附属医院脊柱外科，贵州省遵义市  563000
  • 收稿日期:2016-04-26 出版日期:2016-06-17 发布日期:2016-06-17
  • 通讯作者: 曹广如，硕士，副主任医师，遵义医学院附属医院脊柱外科，贵州省遵义市 563000
  • 作者简介:覃建朴，男，1975年生，贵州省人，布依族，2010年遵义医学院毕业，硕士，主治医师。 并列第一作者：王翀，男，1983年生，汉族，河南省人，2011年遵义医学院毕业，硕士，主治医师。
  • 基金资助:

    贵州省卫生厅科学技术基金项目(gzwkj2013-1-011)

 Different bone graft fusion materials applied in lumbar interbody fusion

Qin Jian-pu, Wang Chong, Zhang Peng-yun, Cao Guang-ru, Cai Yu-qiang, Liao Wen-bo   

  1. Department of Spine Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • Received:2016-04-26 Online:2016-06-17 Published:2016-06-17
  • Contact: Cao Guang-ru, Master, Associate chief physician, Department of Spine Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • About author:Qin Jian-pu, Master, Attending physician, Department of Spine Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China Wang Chong, Master, Attending physician, Department of Spine Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China Qin Jian-pu and Wang Chong contributed equally to this work.
  • Supported by:

    the Science and Technology Foundation of Guizhou Provincial Health Department, China, No. gzwki2013-1-011

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318

被引次数

5

摘要：

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文题释义：
脊柱融合：是目前脊柱外科最为常见的手术治疗方法，该手术在腰椎间盘突出症、腰椎滑脱症等疾病中运用较多。但是，脊柱融合治疗方法时影响因素相对较多，且患者治疗后缺乏手术成功、失败统一指标，术后难以对脊柱融合进行单因素分析。同时，脊柱融合治疗过程中移植材料选择中也存在较大争议。
骨形态发生蛋白：属于一种多分支二聚物，由氨基酸以及胖氨酸残基等经过化学键链接而成，属于是一种疏水性蛋白，对碱性比较敏感。骨形态发生蛋白广泛存在于动物骨骼和牙齿中，在机体内必须经过载体才能够促进骨的形成，进一步提高脊椎融合率，且该物质与载体的类型、剂量等关系密切。

 

摘要
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)；②Oswestry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。

 

ORCID: 0000-0003-1981-1359(曹广如)

关键词: 生物材料, 骨生物材料, 植骨融合材料, 犬腰椎椎体间脊柱融合, 应用效果, 自体骨, 重组人骨形态发生蛋白, 功能障碍指数, 组织学, 同种异体骨, 生物陶瓷, 生物力学

Abstract:

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 enrolled 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 allograft 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 gradually 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 allogeneic bone grafts.

 

 

 

Key words: Tissue Engineering, Biocompatible Materials, Spine, Bone Transplantation, Biomechanics

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