组合磁场辅助治疗纳米羟基磷灰石／双相磷酸钙移植兔腰椎后外侧融合形态学研究  

Morphology analysis of nano hydroxyapatite/biphasic calcium phosphate for posterlateral lumbar fusion after combined magnetic field -an experimental study in rabbit

作　　者：卓祥龙 胡建中[2] 李兵 吕红斌[3] 吴祖同[2] 周京泳[3] 徐大启[3] 段春岳[2] 

机构地区：[1]广西省柳州市工人医院脊柱外科,柳州545001 [2]中南大学湘雅医院脊柱外科,长沙410008 [3]中南大学湘雅医院运动医学科,长沙410008

出　　处：《中华实验外科杂志》2016年第6期1614-1618,共5页Chinese Journal of Experimental Surgery

摘　　要：目的探讨组合磁场（CMF）治疗及纳米羟基磷灰石（nano—HA）涂层对双相磷酸钙（BCP）人工骨移植兔腰椎后外侧融合形态学。方法48只兔根据骨移植物及CMF治疗随机分成6组（G1～G6）并进行腰椎后外侧融合（PLF）。术后1周开始CMF治疗，30min／d，治疗8周后处死实验动物。场发射透视电子显微镜（FESEM）、组织学及骨形态发生蛋白-2（BMP-2）和转化生长因子-β1（TGF—β1）表达分析。结果横突间形成连续骨桥，新生骨小梁长人生物支架内，形成骨性结合。G1-C6各组组织学融合评分分别为（7．25±1．16）、（5．00±0．76）、（5．88±1．64）、（5．87±1．25）、（6．50±1．60）和（5．25±1．91）分，CMF治疗和nano—HA涂层显著提高脊柱融合率、融合评分（P〈0．05）。G2、C3、G5和G6组人工骨内胶原矿化率评分分别为（3．125±0．640）、（3．625±0．520）、（2．875±0．830）和（3．375±0．520）分，nano—HA涂层显著提高人工骨内胶原矿化率，BMP-2在G2、G3、G5和G6组表达平均吸光度值分别为0．177±0．057、0．169±0．030、0．088±0．049和0．109±0．038；TGF-β1在G2、G3、G5和C6组表达平均吸光度值分别为0．155±0．023、0．144±0．031、0．097±0．027和0．100±0．037。CMF显著提高融合区BMP-2和TGF-β1表达（P〈0．05）。结论CMF和nano—HA涂层都能够促进脊柱融合，改善融合效果。CMF联合nano—HA／BCPP移植PLF可作为一种新的脊柱融合方式。Objective To analyze morphology of nano hydroxyapatite （nano- HA） coating and combined magnetic field （CMF） treatment on rabbits posterlateral lumbar fusion （PLF）. Methods 48 a- dult rabbits undergone bilateral intertransvexse processes fusion at the level of L5 - 6 were randomly divided into six groups G1 , G2, G3 , G4, G5 and G6 according to grafts used and CMF treatment. Group G1 re- ceived autologous iliac bone graft （AIBG） and CMF treatment; Group G2, nano- HA/biphasic calcium phosphate （BCP） ＋ CMF; Group G3, BCP ＋ CMF; Group G4, AIBG ＋ placebo; Group Gs, nano - HA/ BCP ＋ placebo; Group G6, BCP ＋ placebo. CMF treatments began at postoperative 1 week for 8 weeks, 30 minutes a day. The animals were euthanized at postoperative 9 weeks. Analyses included Field Emission Transmission Electron Microscope （ FESEM）, bone morphogenetic protein - 2 （ BMP - 2 ） and transforming growth factor - β1 （TGF - β1 ） expression by immunohistochemistry and histological analysis. Results The biological scaffold were covered with new bone callus and bone ingrowth. Continuous bone bridge formed between the L5 and L6 transverse process in some specimens. The histological fusion score in G1 - G6 group was 7.25 ± 1.16, 5.00 ±0.76, 5.88 ± 1.64, 5.87 ± 1.25, 6. 50 ± 1.60 and 5.25 ± 1.91. CMF and nano - HA coating significantly improved the spinal fusion rate, fusion score （ P 〈 0.05 ）. The artificial bone collagen mineralization rate score in G2, G3, G5 and G6 group was 3. 125 ±0. 640, 3. 625 ± 0. 520, 2. 875 ± 0. 830 and 3. 375 ± 0. 520, nano - HA coating significantly increased the collagen mineralization in the biological scaf fold pore. The average optical density of BMP -2 in G2, G3, G5 and G6 groups were O. 177 ＋ 0. 057, 0. 169 ± 0. 030, 0. 088 ± 0. 049 and 0. 109 ± 0. 038, respectively. In TGF- β1, G3, G2, G5 and G6 groups, the average light density was 0. 155 ± 0. 023, 0. 144 ± 0. 031, 0. 097±0. 027 and 0. 100 ±0. 037, respectively. CMF significantly increased

关 键 词：纳米羟基磷灰石涂层 组合磁场 双相磷酸钙 腰椎后外侧融合 

分 类 号：R687.3[医药卫生—骨科学]