人工骨腰椎后外侧融合过程中BMP基因的表达  

Bone morphogenetic protein(BMP) gene expression during lumbar spinal posterolateral fusion with artificial bone material

作　　者：季峰[1] 赵剑[1] 施红光[1] 赵敦炎[1] 谭湘陵[1] 侍德[1] 

机构地区：[1]江苏省南通医学院附属医院骨科,南通226001

出　　处：《中国矫形外科杂志》2005年第4期278-281,共4页Orthopedic Journal of China

基　　金：江苏省卫生厅基金资助课题(编号:H200111)

摘　　要：目的研究利用人工骨做脊柱后外侧融合时局部BMP的表达情况,探讨人工骨在此过程中是否具备骨诱导作用。方法选用36只健康成年雄性新西兰白兔,制作L4、L5双侧横突间植骨融合模型,一侧采用磷酸钙人工骨(CPC),另一侧采用自体骨作为对照。按术后动物不同处死时间(0、2、4d、1、2、3、4、5、6、10周、6、10个月)随机平分为12组。采用RTPCR法检测融合组织BMP2mRNA、BMP4mRNA的表达水平。结果CPC材料内部在融合的各个时间段均未检测到BMP2mRNA和BMP4mRNA的表达。与紧密结合的植骨床及融合交界面中BMP2mRNA和BMP4mRNA的表达水平随时间变化均没有明显的增高,与自体骨相比,CPC融合过程中不同时间段内BMP2mRNA、BMP4mRNA的表达水平均明显低于自体骨(P<0.05)。结论单纯利用CPC做脊柱融合时,局部缺乏BMP的有效表达,可能导致融合失败率的增加。Objective:To study whether or not artificial bone material has bone inductive characteristics by detecting expression of bone morphogenetic protein (BMP) after lumbar spinal posterolateral fusion with the calcium phosphate cement(CPC ) artificial bone. Method:Thirty-six healthy male adult New Zealand rabbits, used as animal models, underwent single-level bilateral posterolateral intertransverse process lumbar spinal arthrodesis at L_4-L_5, the calcium phosphate cement (CPC ) artificial bone graft was placed on one side and autogenous iliac crest bone graft on the contralateral side. The animals were divided into 12 groups based on the killing time after surgery (0,2,4 days,1,2,3,4,5,6,10 weeks and 6,10 months). BMP_2 and BMP_4 mRNA in fusing tissue were determined by reverse transcription polymerase chain reaction(RT-PCR).Result:No BMP_2 and BMP_4 mRNA were detected from CPC materials interior at any time but some were found at immediate contact to the cement. The expression levels of BMP_2 and BMP_4 mRNA detected at immediate contact to the cement,no change with time(P<0.05) were significantly lower than the expression from the side autogenous iliac crest bone(P<0.05).Conclusion:Spinal fusion by only CPC ,bare of enough expression of BMP, might give raise to increasing of nonunion.

关 键 词：融合术 磷酸钙骨水泥 骨形态发生蛋白 脊柱 

分 类 号：R687[医药卫生—骨科学]