腹腔镜下多孔自固化磷酸钙人工骨复合重组人骨形态发生蛋白2在山羊腰椎体间融合中的作用  

Experimental study of laparoscopical lumbar interbody fusion with polyporus composite phosphate calcium and rhBMP-2 compounds in sheeps

作　　者：朱志海 曹鹏[2] 梁裕[2] 龚耀成[2] 郑涛[2] 张兴凯[2] 吴文坚[2] 

机构地区：[1]临海市第二人民医院骨科,浙江317016 [2]上海交通大学医学院附属瑞金医院骨科上海市伤骨科研究所

出　　处：《中华医学杂志》2010年第21期1503-1506,共4页National Medical Journal of China

基　　金：上海市科学技术委员会自然科学基金（0221314083）

摘　　要：目的 通过腹腔镜技术行山羊椎体间融合,研究新型多孔自固化磷酸钙复合重组人骨形态发生蛋白2（rh-BMP2）的骨性融合情况.方法 选择14只体重均匀、成年山羊随机分为3组,行L4～L5椎间盘摘除＋椎体间钛网植骨融合术.A组：切开自体骨钛网组;B组：镜下合成骨钛网组（CPC组）;C组：镜下含rhBMP-2的合成骨钛网组（CPC/rhBMP-2组）（6只）.于术后6、12周分批处死动物,进行大体标本、组织切片,影像学检查及生物力学分析.结果 腹腔镜下椎间盘软骨终板的平均切除率与切开组无统计学差异,术后3个月3组均获得骨性融合,但镜下CPC/rhBMP-2组的骨痂出现较前两组早,骨痂量多.结论 新型多孔自同化磷酸钙复合rh-BMP2在腹腔镜技术下能够达到山羊椎体间骨性融合,可作为一种合适的修复材料复合物,以期临床应用.Objective To study the efficacy of polyporus composite phosphate calcium and rhBMP- 2 compounds with laparoscopical lumbar interbody fusion in sheeps. Methods Fourteen uniform-weight adult sheeps were randomly divided into three groups for L4-5 interbody fusion with titanium mesh. Autogenous bone and titanium mesh was applied with open anterior technique in group 1 （n = 4）. In group 2, 4 sheeps were operated with laparoscope technique for L4-5 interbody fusion with composite phosphate calcium （CPC） and titanium mesh. In group 3, 6 sheeps underwent laparoscopical L4-5 interbody fusion with titanium mesh as well as polyporus composite phosphate calcium and rhBMP-2 compounds. At Weeks 6 and 12 post-operation, the sheeps were sacrificed for imaging, biomechanic and morphological examinations. Results Although there was no statistical difference between open and laparoscopical interbody fusion group when comparing the remaining disc and endplate decorticated, bone fusion occurred in 3 groups after 3 months. A much larger amount of bony callus was observed earlier in laparoscopical L4-5 interbody fusion group with titanium mesh as well as polyporus composite phosphate calcium and rhBMP-2 compounds than two other groups. Conclusion Polyporus composite phosphate calcium and rhBMP-2 compounds are suitable prosthetic materials for clinical trials. When these materials are utilized with a laparoscopical technique, satisfactory interbody fusion may be achieved.

关 键 词：骨形态发生蛋白质类 磷酸钙 脊柱融合术 腹腔镜 

分 类 号：R687.3[医药卫生—骨科学]