多孔双相钙磷陶瓷在脊柱后路融合中成骨作用和降解特性的组织学观察(附20例活检分析)  

Tissue reactions of porous biphasic calcium phosphate ceramic in posterior spinal fusion

作　　者：谢幼专[1] 朱振安[1] 张蒲[1] 汤亭亭[1] 卢建熙[1] 戴尅戎[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院骨科,上海200011

出　　处：《中国矫形外科杂志》2008年第8期617-620,共4页Orthopedic Journal of China

基　　金：国际科技合作重点项目(No2005DFA30120);国家自然科学基金项目(No30600629)

摘　　要：[目的]了解多孔双相钙磷陶瓷在人体脊柱后路融合中的成骨变化及降解过程。[方法]对20例脊柱后路融合的双相钙磷陶瓷活检标本行不脱钙硬组织切片检查。观察陶瓷周围和内部的新生组织、陶瓷的形态改变、降解颗粒及伴随的细胞吞噬反应。其中14例标本行组织形态计量,根据患者的年龄、植入时间及临床结果分组比较成骨及材料降解的速度。[结果]所有的双相钙磷陶瓷标本均可见新生骨组织,与自体骨接触越多,陶瓷内的新生骨组织越多。绝大部分陶瓷内可见降解颗粒,部分颗粒位于巨噬细胞内。不同标本的新生骨和材料降解速度差异较大。陶瓷内的新生骨随植入时间的增加而增多,但随患者年龄的增大而减少。陶瓷的降解率随患者年龄的增大而减少,但不受植入时间的影响。后路融合成功组的活检标本的新生骨量高于融合失败组,但材料降解率则反之。[结论]多孔双相钙磷陶瓷是一种骨传导材料,但植入体内降解缓慢,不能被新生骨组织完全替代。植入时必须将陶瓷与自体骨充分混合以获得良好的骨长入。陶瓷产生的降解颗粒及诱发的细胞吞噬反应必须引起注意。[ Objective] To reveal the osteogenesis, the biodegradafion and tissue reactions of the porous biphasic calcium phosphate ceramic （PBC） in human spine. [ Method ] The histological study was carried out on 20 PBC samples retrieved from posterior spinal fusion. All the PBC samples were treated by undecalcified histological preparation. The tissue in or around the material, the change of ceramic shape, the particles and the presence of macrophages were observed. The quantitative study was performed in 14 samples with sufficient size. The residual material and the newly formed bone were analyzed according to the patient age, the duration in vivo and clinical results. [ Result ] Newly formed bone was found in all the samples. More new bone was formed in those samples closely in contact with autogenous bone. The PBC degradation particles were present both in the macrophages and around the tissue. But those phenomena were highly variant among the samples. New bone formation increased with time and decreased with the age. The material degradation decreased with the age, hut it did not differ greatly with time. New bone formation was higher and the residual material was lower in the fusion group than in the non-fusion group. [ Conclusion] The PBC is a kind of osteoconductive material and does not transform into new bone after a relatively long time. The PBC should he well mixed with the autogenous bone in order to achieve high new bone colonization. The PBC degradation particles and related active phagocytotic activity have been noted.

关 键 词：脊柱后路融合 双相钙磷陶瓷 骨形成 生物降解 

分 类 号：R687[医药卫生—骨科学]