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山东大学学报(医学版)

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不同植骨材料椎间融合效果的实验研究

袁振灿,郑燕平,刘新宇,贾龙,李伟,李小斌   

  1. 山东大学齐鲁医院骨外科, 济南 250012
  • 收稿日期:2007-11-01 修回日期:1900-01-01 出版日期:2008-03-16 发布日期:2008-03-16
  • 通讯作者: 郑燕平

Lumbar interbody spinal fusion with different materials: an experimental study

YUAN Zhen-can, ZHENG Yan-ping, LIU Xin-yu, JIA Long, LI Wei, LI Xiao-bin   

  1. Department of Orthopadics Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2007-11-01 Revised:1900-01-01 Online:2008-03-16 Published:2008-03-16
  • Contact: ZHENG Yan-ping

摘要: 目的观察不同植骨融合材料在兔腰椎椎体间脊柱融合的愈合情况,探讨不同的植骨材料替代自体骨用于腰椎椎体间融合的可能性。方法试验组分5组:空白对照组、自体骨组、同种异体骨组、生物陶瓷+自体骨组、重组人骨形态发生蛋白(rhBMP-2)复合体组。椎体间移植后4、8、12周,通过大体观察、手法检测、影像学、生物力学和组织学方法评价脊柱愈合情况。结果术后12周,大体及手法检测显示空白对照组不能自行达到脊柱融合,融合率为0%(0/12);自体骨组脊柱融合率为83.3%(10/12);同种异体骨组为66.7%(8/12);生物陶瓷+自体骨组融合率为66.7%(8/12);rhBMP-2复合体组为100%(12/12),组织学显示成骨早,新骨形成量大,降解快,生物力学测试结果表明,自体骨组与同种异体骨组和生物陶瓷+自体骨组差异无统计学意义(P>0.05),rhBMP-2复合体组优于其它组(P<0.05)。结论同种异体骨、生物陶瓷+自体骨、rhBMP-2复合体均能替代自体骨行脊柱椎体间融合,rhBMP-2复合体更能促进脊柱愈合,提高脊柱愈合的生物力学强度。

Abstract: To evaluate the efficacy of different material fillings in an experimental model of lumbar interbody spinal fusion in rabbits. MethodsAnimals were randomly divided into five experimental groups:the control group, the autogenous iliac bone graft group, the allogeneic bone graft group, the autogenous iliacbioceramics composites group and the rhBMP-2 composite group. All grafts were stuffed in vivo. Gross inspection, manual palpation, radiography, biomechanical testing and histology were used to evaluate the spinal fusion 4, 8, and 12 weeks after the operations. ResultsNone had solid spinal fusion at 12 weeks in the control group; 83.3% of the animal had spinal fusion in the autogenous iliac bone graft group; 66.7% of animals in the allogeneic bone graft group and 66.7% in the autogenous iliacbioceramics composite group had solid spinal fusion; all had spinal fusion in the rhBMP-2 composite group. ConclusionAllogeneic bone, autogenous iliac -bioceramics composites and rhBMP-2 composites could be used for interbody spinal fusion as an alternative of autogenous iliac bone graft for clinic treatment, furthermore BMP-2 could mechanically accelerate spinal fusion.

Key words: Spinal fusion, Autograft, Allograft, Ceramics, Bone morphogenetic proteins

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