脊柱横突间融合治疗中异种脱蛋白松质骨应用的可行性探讨  

Feasibility study on the application of the heterogeneous de protein cancellous bone in the treatment of lumber lntertransverse process spinal fusion

作　　者：贺学军[1] 倪江东[1] 

机构地区：[1]中南大学湘雅二医院骨科,长沙410013

出　　处：《中国医师杂志》2016年第11期1666-1670,共5页Journal of Chinese Physician

摘　　要：目的探讨脊柱横突间融合治疗中应用异种脱蛋白松质骨的可行性。方法选取6—8月龄健康雄性青山羊30只，制备横突间植骨床，按随机数字表法分为I组和Ⅱ组，每组15只。I组于左侧植入组织工程骨（A组），右侧植入重组人骨形态发生蛋白-2（rhBMP-2）复合骨（B组），Ⅱ组于左侧植入自体骨（c组），右侧植入单纯异种脱蛋白松质骨（D组），观察各组X线、组织学形态以及最大弯曲载荷。结果（DB组和D组术后4、8、12周x线评分均低于C组（P〈0．05）；A组术后4、8、12周X线评分分别为（5．30±0．41）分、（8．54±0．89）分和（11．25±0．91）分，与C组各期比较差异无统计学意义（P〉0．05）。（2）A组、B组和D组术后4、8周组织学评分均低于C组（P〈0．05）；A组术后4、8周组织学评分高于B组和D组（P〈0．05）；B组和D组术后12周组织学评分低于c组（p〈0．05）；A组术后12周组织学评分为（11．04±1．52）分，与C组比较差异无统计学意义（P〉0．05）。（3）B组和D组最大弯曲载荷低于C组（P〈0．05）；A组最大弯曲载荷为（60．32±10．10）N，与C组比较差异无统计学意义（P〉0．05）。结论异种脱蛋白松质骨为载体构建组织工程骨成骨性能接近自体骨，但单纯异种脱蛋白松质骨成骨差。Objective To investigate application feasibility of the heterogeneous de protein cancellous bone in the treatment of lumber intertransverse process spinal fusion. Methods Thirty 6-8 month healthy male goats were selected to make intertransverse bone bed, and were randomly divided into groups Ⅰ and Ⅱ, with 15 in each group. Group I was the left side implanted the tissue engineering bone （A group）, and the right side implanted recombinant human bone morphogenetic protein-2 （rhBMP-2） com- posite bone （ B group） ; Group Ⅱ was the left implanted autologous bone （ C group）, and the right side implanted simple heterogeneous de protein cancellous bone （D group）. Each groUp was observed with the X- ray, histological morphology, and maximum bending load. Results （1） In groups B and D, postoperative 4-, 8- and 12-week X-ray scores were lower than that of group C （ P 〈 0.05 ） ; In group A, postoperative 4-, 8- and 12-week X-ray score were （ 5.30±0.41 ） points, （ 8. 54 4- 0. 89 ） points, and （ 11.25±0. 91 ） points, compared to group C, without statistically significant difference （P 〉 0. 05） ; （2） For groups A, B and D, postoperative 4- and 8-week histological scores were significantly lower than those in group C （P 〈 O. 05）. For group A, postoperative 4- and 8-week histological scores were significantly higher than those of groups B and D （P 〈0. 05）. The histological scores of groups B and D postoperative 12 weeks were lower than those of group C （P 〈0. 05）. The histological score of group A postoperative 12 weeks was （11.04±1.52） points, compared to group C without statistically significant difference （ P 〉 0. 05 ） ; （3） The maximum bending load of groups B and D was lower than that of group C （P 〈 0. 05 ）. The maximum bending load of group A was （60. 32±10. 10） N, compared to group C without statistically significant difference （ P 〉 0.05）. Conclusions The construction of tissue engineered bone by the heterogeneou

关 键 词：脊柱融合术 骨移植 骨和骨组织 组织工程 移植 异种 

分 类 号：R687.3[医药卫生—骨科学]