Evaluation of OP-1 as a Graft Substitute for Intertransverse Process Lumbar Fusion
Evaluation of OP-1 as a Graft Substitute for Intertransverse Process Lumbar Fusion
复制标题
OP-1 作为横突间腰椎融合移植物替代品的评价
作者：
J. Grauer;T. Patel;J. Erulkar;N. Troiano;M. Panjabi;G. Friedlaender
研究设计.建立兔横突间腰椎融合模型，评价成骨蛋白（OP）-1作为潜在移植物替代物的价值。目标.确定OP-1在兔模型中是否有效产生横突间腰椎融合。背景数据总结。自体髂嵴骨是诱导横突间融合的移植材料的金标准。然而，骨移植替代物被认为是实现这种融合的补充或替代手段，发病率较低。相对较少的研究已进行调查的有效性OP-1在这方面的作用。方法.在31只新西兰白色兔的L5-L 6节段进行单节段横突间腰椎融合。这些被分为三个研究组：自体移植物、单独载体和载体与OP-1。手术后5周处死动物。通过手动触诊、X线摄影、生物力学多向柔韧性测试和组织学对融合块进行评价。结果7只家兔（23%）因并发症被排除。在剩余的24只家兔中，自体移植物组8只中的5只（63%）通过手动触诊检测到融合，单独载体组8只中无融合（0%），OP-1组所有8只（100%）融合。X线片对确定融合的敏感性为55%，特异性为92%。生物力学测试结果与手动触诊结果相关性良好。组织学上，自体移植物标本主要是纤维软骨，OP-1标本主要是成熟骨，单独载体标本未显示出显著的骨形成。结论.发现OP-1在5周时在兔模型中可靠地诱导固体横突间融合。
Study Design. An established rabbit intertransverse process lumbar fusion model was used to evaluate osteogenic protein (OP)-1 as a potential graft substitute. Objectives. To determine whether OP-1 is effective in producing intertransverse process lumbar fusion in a rabbit model. Summary of Background Data. Autogenous iliac crest bone is the gold standard in grafting material for inducing intertransverse process fusion. However, bone graft substitutes are being considered as supplementary or alternative means to achieve such fusion with less morbidity. Relatively little research has been undertaken to investigate the efficacy of OP-1 in this role. Methods. Single-level intertransverse process lumbar fusions were performed at L5–L6 of 31 New Zealand White rabbits. These were divided into three study groups: autograft, carrier alone, and carrier with OP-1. The animals were killed 5 weeks after surgery. Resultant fusion masses were evaluated by manual palpation, radiography, biomechanical multidirectional flexibility testing, and histology. Results. Seven rabbits (23%) were excluded because of complications. Of the remaining 24 rabbits, 5 (63%) of the 8 in the autograft group had fusion detected by manual palpation, none (0%) of the 8 in the carrier-alone group had fusion, and all 8 (100%) in the OP-1 group had fusion. Radiographs were 55% sensitive and 92% specific for determining fusion. Biomechanical testing results correlated well with those of manual palpation. Histologically, autograft specimens were predominantly fibrocartilage, OP-1 specimens were predominantly maturing bone, and carrier-alone specimens did not show significant bone formation. Conclusions. OP-1 was found to reliably induce solid intertransverse process fusion in a rabbit model at 5 weeks.