中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (25): 4571-4575.doi: 10.3969/j.issn.1673-8225.2012.25.003

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

负载骨形态发生蛋白新型骨填充材料应用于椎体成形

钱 光，杨文成，王明海，董有海   

  1. 复旦大学附属上海市第五人民医院骨科，上海市 200240
  • 收稿日期:2011-11-08 修回日期:2011-11-08 出版日期:2012-06-17 发布日期:2013-11-04
  • 通讯作者: 董有海，主任医师，副教授，复旦大学附属上海市第五人民医院骨科，上海市 200240 dongyouhai @5thhospital. com
  • 作者简介:钱光★, 男，1979年生，回族，河南省睢县人，2005年同济大学毕业，硕士，主治医师，主要从事脊柱外科方面的研究。 qianguang1979@163.com
  • 基金资助:

    复旦大学青年骨干科研启动基金资助项目(2008YXY-02)；上海市闵行区自然科学基金资助项目(2009MHZ116)

A new type of bone stuff with bone morphogenetic protein is used in vertebroplasty

Qian Guang, Yang Wen-cheng, Wang Ming-hai, Dong You-hai   

  1. Department of Orthopedics, the Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China
  • Received:2011-11-08 Revised:2011-11-08 Online:2012-06-17 Published:2013-11-04
  • Contact: Dong You-hai, Chief physician, Associate professor, Department of Orthopedics, the Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China dongyouhai @5thhospital.com
  • About author:Qian Guang★, Master, Attending physician, Department of Orthopedics, the Fifth People’s Hospital of Shanghai, Fudan University, Shanghai 200240, China qianguang1979@ 163.com

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摘要：

背景：磷酸钙骨水泥克服了聚甲基丙烯酸甲酯的诸多缺点并具有良好的生物相容性。而负载复合重组人类骨形态发生蛋白2的磷酸钙骨水泥经固化后可具有微孔结构，可提高经皮椎体成形充填材料的临床价值。
目的：探讨以可注射型磷酸钙骨水泥和纤维蛋白胶作为共同载体，复合重组人类骨形态发生蛋白2，替代聚甲基丙烯酸甲酯应用于新西兰大白兔椎体成形的可行性。
方法：制备磷酸钙骨水泥/纤维蛋白胶/复合重组人类骨形态发生蛋白2新型复合材料。采用小鼠肌袋异位诱导成骨模型对不同植入材料进行骨诱导活性评价；模仿椎体成形观察新型复合材料和聚甲基丙烯酸甲酯植入兔椎体后的生物力学改变。
结果与结论：新型复合材料植入后2，4周碱性磷酸酶水平最高，植入后4周软骨细胞逐渐成熟，新骨形成，抗压强度和抗扭转强度明显低于正常椎体和聚甲基丙烯酸甲酯植入后(P < 0.05)，8周后材料被进一步降解，抗压强度和抗扭转强度均有所上升，扛扭转强度与正常椎体相比无显著差别，但仍明显低于聚甲基丙烯酸甲酯(P < 0.05)。microCT提示其新生骨形成多而早，但聚甲基丙烯酸甲酯未见材料吸收及周围骨质长入。说明新型复合材料植入椎体后能够获得良好的骨诱导和骨传导功能，材料降解和新骨替代同步，接近于正常椎体的骨愈合，可望替代聚甲基丙烯酸甲酯应用于椎体成形。

关键词: 聚甲基丙烯酸甲酯, 磷酸钙类, 骨形态发生蛋白质类, 组织学, 椎体成形, 生物材料

Abstract:

BACKGROUND: Calcium phosphate bone cement (CPC) has good biocompatibility and no disadvantages of polymethyl methacrylate (PMMA). CPC with recombinant human bone morphogenetic protein-2 (rhBMP-2) has a microporous structure, and its clinical value can be improved in percutaneous vertebroplasty.
OBJECTIVE: To evaluate the feasibility of injectable CPC and fibrin sealant (FS) combined with rhBMP-2 in vertebroplasty of New Zealand white rabbits to replace PMMA.
METHODS: CPC/FS/rhBMP-2 was prepared. Tight muscle pouch model in mice was used to evaluate the osteoinductive activities of the implant materials. Imitation of vertebral plasty was used to observe the biomechanical changes of new composite material and PMMA after their implantation.
RESULTS AND CONCLUSION: At 2 and 4 weeks of CPC/FS/rhBMP-2 implantation, alkaline phosphatase levels were the highest. At 4 weeks of CPC/FS/rhBMP-2 implantation, new bone formation and chondrocyte maturation could be seen, and the compressive strength and torsion strength were obviously lower than those of the normal vertebral and PMMA implantation (P < 0.05). After 8 weeks of implantation, part of the CPC/FS/rhBMP-2 cement was degraded with some increases in compressive strength and torsion strength, and the torsion strength was similar with that of the normal vertebral, but was lower than that of PMMA implantation (P < 0.05). Micro CT showed that the new bone was plenty and its formation was in the early stage, and there was no material absorption or surrounding bone ingrowth could be seen in PMMA. It is indicated that good bone induction and bone conduction can be obtained after CPC/FS/rhBMP-2 implantation, and the degradation of CPC/FS/rhBMP-2 can synchronize with new bone formation to achieve normal bone healing. CPC/FS/rhBMP-2 is expected to replace PMMA in vertebral plasty.

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