Lumbar spinal fusion with a mineralized collagen matrix and rhBMP-2 in a rabbit model
Lumbar spinal fusion with a mineralized collagen matrix and rhBMP-2 in a rabbit model
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DOI：
10.1097/01.brs.0000083240.13332.f6
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发表时间：
2003-09-01
期刊：
影响因子：
3
通讯作者：
Sun, TS
中科院分区：
文献类型：
--
作者：
Liao, SS;Guan, K;Sun, TS
研究设计.本研究采用一种新的矿化胶原基质结合或不结合生长因子用于兔腰椎后外侧融合。新的骨传导基质（含或不含重组骨诱导生长因子）的可用性为自体骨移植适应症提供了一种可能的替代方法。本研究评价了仿生基质：纳米羟基磷灰石/胶原/聚乳酸（nHAC/PLA）与重组人骨形态发生蛋白-2（rhBMP-2）在兔后外侧脊柱融合中的成骨活性。骨移植材料有钛合金、陶瓷、高分子材料等。但是，每一种都有其特定的劣势。永久性种植体在体内仍有被侵蚀的可能性，这是由于后期破裂和脓肿形成造成的。聚合物生物降解的酸性结果也对骨修复的后期结果产生负面影响。它需要一种有前途的材料，以替代使用自体骨移植适应症。材料与方法。将64只家兔随机分为4组：自体髂骨组（ACB）、nHAC/PLA复合组（nHAC/PLA）、自体髂骨与nHAC/PLA复合组（ACB + nHAC/PLA）、nHAC/PLA复合重组人BMP-2组（nHAC/PLA + rhBMP-2）。在10周的观察期内，通过触诊、影像学、组织学、机械强度和扫描电镜（SEM）对腰椎横突间融合进行评估。ACB + nHAC/PLA和nHAC/PLA + rhBMP-2组的最佳配方在术后6周和10周的融合率和机械强度方面与ACB相似。从显微结构分析来看，复合材料植入自体髂嵴后无不良影响，植入未复合rhBMP-2的复合材料后第2周早期也有新的类骨组织形成。本研究显示了nHAC/PLA在兔后外侧脊柱融合中联合rhBMP-2的有效结果。通过将这种骨传导基质与生长因子复合，这是自体移植的替代方法。
Study Design. A new mineralized collagen matrix combined with or without growth factor was used for the posterolateral spinal fusion in the rabbit lumbar spine.Objectives. The availability of a new osteoconductive matrix with or without recombinant osteoinductive growth factors offers a possible alternative to the use of autogenous bone for grafting indications. This study evaluated the bone-forming activity of the biomimetic matrix: nano-hydroxyapatite/collagen/polylactic acid (nHAC/PLA) combined without or with recombinant human bone morphogenetic protein-2 (rhBMP-2) in a rabbit posterolateral spinal fusion.Summary of Background Data. Many bone grafting materials such as titanium alloy, ceramics, and polymers were used to repair bony defects. However, each has specific disadvantaged. The permanent implantation still has possibility to be eroded in vivo, which is caused by late breakdown and abscess formation. The acidic outcome of polymer biodegradation was also negatively affected in the later-stage results of bone repair. It needed a promising material for an alternative to the use of autogenous bone for grafting indications.Materials and Methods. Sixty-four rabbits were randomly divided into four groups: autologous iliac crest bone group (ACB), nHAC/PLA composite group (nHAC/PLA), autologous iliac crest bone mixed with nHAC/PLA composite group (ACB + nHAC/PLA), nHAC/PLA composite with recombinant human BMP-2 group (nHAC/PLA + rhBMP-2). The lumbar intertransverse process fusions were assessed by manual palpation, radiographic, histologic, and mechanical strength, and scanning electronic microscopy (SEM) in a 10-week observation.Results. Optimal formulations of the ACB + nHAC/PLA and nHAC/PLA + rhBMP-2 groups were shown to perform similar to ACB in both the fusion ratio and mechanical strength in the 6 and 10 weeks after surgery. From the microstructure analysis of the samples, there was no negative effect when the compound implanted this composite with autogenous iliac crest, and there was also new bone-like tissue formation implanted this composite without combined rhBMP-2 early at the second week after surgery.Conclusions. This study shows the effective results of nHAC/PLA in rabbit posterolateral spinal fusion combined with rhBMP-2. It is an alternative method to autograft by compounding this osteoconductive matrix with growth factors.