Ceramic granules enhanced with B2A peptide for lumbar interbody spine fusion: an experimental study using an instrumented model in sheep Laboratory investigation
Ceramic granules enhanced with B2A peptide for lumbar interbody spine fusion: an experimental study using an instrumented model in sheep Laboratory investigation
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DOI：
10.3171/2009.1.spine08565
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发表时间：
2009-04-01
影响因子：
2.8
通讯作者：
McAfee, Paul C.
中科院分区：
文献类型：
--
作者：
Cunningham, Bryan W.;Atkinson, Brent L.;McAfee, Paul C.
Object.生物活性肽和多孔植入物的联合使用有望产生新一代脊柱椎间融合器械。本剂量范围研究的目的是通过在绵羊中使用器械腰椎椎间融合模型来评估涂覆有生物活性肽B2 A2-K-NS（B2 A）的多孔陶瓷颗粒（CG）的融合特性。在20只成年绵羊的40个手术部位进行了脊柱内固定术。在每只动物中，在2个单节段手术（L2-3和L4-5）中放置后路内固定（椎弓根螺钉和棒）和聚醚醚酮椎间融合器。所有融合器在植入前均填充有移植物材料。通过混合（1：1体积/体积）具有或不具有B2 A涂层的CG和微粒化自体移植物来制备移植物材料。陶瓷颗粒涂覆有50、100、300和600 μ g/ml颗粒的B2 A（分别为50-B2 A/CG、100-B2 A/CG、300-B2 A/CG和600-B2 A/CG），得到4个B2 A涂覆组和一个对照组（未涂覆的CG）。将每组的移植物材料植入8个手术部位。关节融合术后4个月，通过CT评估椎间融合状态，并通过定量组织形态学进一步评估椎间部位。所有B2 A/CG组的CT证实椎间融合率均高于对照组（仅CG）。在50-B2 A/CG、100-B2 A/CG和300-B2 A/CG组中，8个位点中有7个融合，而在接受未涂层CG的组中，8个位点中有5个融合。新编织骨和板层骨跨越融合部位，骨整合良好。在任何组中，均未发生归因于B2 A/CG使用的异位骨化或其他不良事件。各B2 A/CG处理组均比CG组产生更多的新骨。B2 A生物活性处理有效地提高了多孔CG的融合能力。这些结果表明，B2 A/CG可能很好地代表了用于腰椎椎间融合的新一代生物材料，并表明需要进行更多的研究。(DOI：10.3171/2009.1.SPINE08565）
Object. New generations of devices for spinal interbody fusion are expected to arise from the combined use of bioactive peptides and porous implants. The purpose of this dose-ranging study was to evaluate the fusion characteristics of porous ceramic granules (CGs) coated with the bioactive peptide B2A2-K-NS (B2A) by using a model of instrumented lumbar interbody spinal fusion in sheep.Methods. Instrumented spinal arthrodesis was performed in 40 operative sites in 20 adult sheep. In each animal, posterior instrumentation (pedicle screw and rod) and a polyetheretherketone cage were placed in 2 single-level procedures (L2-3 and L4-5). All cages were packed with graft material prior to implantation. The graft materials were prepared by mixing (1:1 vol/vol) CGs with or without a B2A coating and morselized autograft. Ceramic granules were coated with B2A at 50,100, 300, and 600 mu g/ml granules (50-B2A/CG, 100-B2A/CG, 300-B2A/CG, and 600-B2A/CG, respectively), resulting in 4 B2A-coated groups plus a control group (uncoated CGs). Graft material from each of these groups was implanted in 8 operative sites. Four months after arthrodesis, interbody fusion status was assessed with CT, and the interbody site was further evaluated with quantitative histomorphometry.Results. All B2A/CG groups had higher CT-confirmed interbody fusion rates compared,with those in controls (CGs only). Seven of 8 sites were fused in the 50-B2A/CG, 100-B2A/CG, and 300-B2A/CG groups, whereas 5 of 8 sites were fused in the group that had received uncoated CGs. New woven and lamellar bone spanned the fusion sites with excellent osseointegration. There was no heterotopic ossification or other untoward events attributed to the use of B2A/CG in any group. Each B2A/CG treatment produced more new bone than that in the CG group.Conclusions. Bioactive treatment with B2A effectively enhanced the fusion capacity of porous CGs. These findings suggest that B2A/CG may well represent a new generation of biomaterials for lumbar interbody fusion and indicate that additional studies are warranted. (DOI: 10.3171/2009.1.SPINE08565)