Fast degradable citrate-based bone scaffold promotes spinal fusion.
Fast degradable citrate-based bone scaffold promotes spinal fusion.
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DOI：
10.1039/c5tb00607d
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发表时间：
2015-07-21
期刊：
影响因子：
--
通讯作者：
Yang J
中科院分区：
文献类型：
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作者：
Tang J;Guo J;Li Z;Yang C;Xie D;Chen J;Li S;Li S;Kim GB;Bai X;Zhang Z;Yang J
脊柱融合术中融合失败和假关节形成的发生率很高（5~35%），这是由于缺乏合适的骨再生材料造成的。柠檬酸盐在增强骨传导性和骨诱导性以及促进骨形成方面发挥着不可或缺的作用。为了解决脊柱融合手术中的材料挑战，我们通过将N-甲基二乙醇胺（MDEA）掺入可点击的聚（1，8-辛二醇柠檬酸酯）（POC-点击）（称为POC-M-点击）中，合成了机械稳健且快速降解的柠檬酸酯基聚合物。将所制备的POC-M-click-HA火柴棒支架与羟基磷灰石（hydroxyapatite，HA）复合，制备成POC-M-click-HA火柴棒支架，用于兔椎体间融合。通过X线摄影、手触诊、生物力学测试和组织学评价分析脊柱融合。在术后4周和8周，POC-M-click-HA支架呈现出最佳降解速率，其促进了更快的新骨形成和更高的脊柱融合率（在第4周和第8周分别为11.2±3.7，80±4.5），而聚（L-乳酸）-HA（PLLA-HA）对照组（9.3±2.4和71.1±4.4）（p<0.05）。P0 C-M-click-HA支架融合的脊椎动物具有的最大载荷和刚度分别为880.8± 14.5N和843.2± 22.4N/mm，其也远高于PLLA-HA组（最大值：712.0± 37.5N，刚度：622.5± 28.4N/mm，p<0.05）。总体而言，结果表明，POC-M-点击-HA支架可能作为脊柱融合应用的有前途的骨移植物。
It is well known that high rates of fusion failure and pseudoarthrosis development (5~35%) are concomitant in spinal fusion surgery, which was ascribed to the shortage of suitable materials for bone regeneration. Citrate was recently recognized to play an indispensable role in enhancing osteconductivity and osteoinductivity, and promoting bone formation. To address the material challenges in spinal fusion surgery, we have synthesized mechanically robust and fast degrading citrate-based polymers by incorporating N-methyldiethanolamine (MDEA) into clickable poly(1, 8-octanediol citrates) (POC-click), referred to as POC-M-click. The obtained POC-M-click were fabricated into POC-M-click-HA matchstick scaffolds by compositing with hydroxyapatite (HA) for interbody spinal fusion in a rabbit model. Spinal fusion was analyzed by radiography, manual palpation, biomechanical testing, and histological evaluation. At 4 and 8 weeks post surgery, POC-M-click-HA scaffolds presented optimal degradation rates that facilitated faster new bone formation and higher spinal fusion rates (11.2±3.7, 80±4.5 at week 4 and 8, respectively) than the poly(L-lactic acid)-HA (PLLA-HA) control group (9.3±2.4 and 71.1±4.4) (p<0.05). The POC-M-click-HA scaffold-fused vertebrates possessed a maximum load and stiffness of 880.8±14.5 N and 843.2±22.4 N/mm, respectively, which were also much higher than those of the PLLA-HA group (maximum: 712.0±37.5 N, stiffness: 622.5±28.4 N/mm, p<0.05). Overall, the results suggest that POC-M-click-HA scaffolds could potentially serve as promising bone grafts for spinal fusion applications.