The Effect of Proton Pump Inhibitors on Bone Formation in a Rat Spinal Arthrodesis Model.
The Effect of Proton Pump Inhibitors on Bone Formation in a Rat Spinal Arthrodesis Model.
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质子泵抑制剂对大鼠脊柱关节固定模型中骨形成的影响。
DOI：
10.1097/brs.0000000000002987
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发表时间：
2019
期刊：
影响因子：
3
通讯作者：
Callaci,JohnJ
中科院分区：
文献类型：
--
作者：
Sonn,KevinA;Wallace,StephenJ;Yuan,FengNingF;Schneider,AndrewD;Hsu,ErinL;Havey,RobertM;Patwardhan,AvinashG;Callaci,JohnJ
研究设计：大鼠后外侧关节融合模型。目的：量化质子泵抑制剂对脊柱融合的影响。背景资料概要：质子泵抑制剂（PPI）广泛用于胃肠道疾病和预防服用非甾体抗炎药患者的溃疡。PPI引起慢性酸抑制，已发现这会导致骨密度降低、骨折风险增加和骨折愈合受损。尽管手术技术不断进步，但在脊柱融合术后需要翻修手术的患者中，仍有高达24%的患者发生假关节。因此，可能存在许多未识别的风险因素。虽然PPIs已被假设为影响骨折愈合，没有研究评估其对脊柱arthrodesisrate.Methods的影响。38只雌性大鼠进行后外侧腰椎融合。将大鼠分为生理盐水对照组和泮托拉唑组，泮托拉唑每日腹腔注射。术后8周，通过手动触诊、microCT、组织学分析和生物力学测试对脊柱进行评估。结果：对照组和PPI组的融合率无显著差异（100% vs. 94%）。泮托拉唑组的平均融合评分显著较低。在双侧融合标本的microCT成像上识别的新骨形成表明PPI组中新生成骨的平均体积较低，但该差异不显著。生物力学测试表明，两组之间融合块的强度或刚度没有显着差异。结论。本研究表明，PPI的给药不会抑制融合率、骨形成，也不会影响融合的生物力学完整性。然而，PPI组的融合评分较低表明可能仍然存在负面影响。未来的研究将探讨生长因子和蛋白质表达的融合群众，以及利用更高剂量的质子泵抑制剂充分辨别其对脊柱fusion.Level的影响证据：N/A尽管已知的负面影响骨健康和骨愈合，质子泵抑制剂通常规定骨科患者的胃肠道疾病。尽管脊柱手术技术和器械不断进步，但假关节的发生率仍然很高。质子泵抑制剂给药对该啮齿动物模型中的融合率没有负面影响。
Study Design.Rat posterolateral arthrodesis model.Objective.Quantify the impact of administration of a proton pump inhibitor on spine fusion.Summary of Background Data.Proton pump inhibitors (PPIs) are widely used for gastrointestinal disorders and for ulcer prophylaxis in patients taking non-steroidal anti-inflammatory drugs. PPIs cause chronic acid suppression which has been found to result in decreased bone mineral density, increased fracture risk, and impaired fracture healing. Despite advances in surgical techniques, pseudarthrosis still occurs in up to 24% of patients requiring revision surgery following spinal fusion procedures. Thus, there are likely many unidentified risk factors. While PPIs have been hypothesized to impact fracture healing, no study has evaluated their effect on spine arthrodesis rates.Methods.Thirty-eight female rats underwent posterolateral lumbar spinal fusion. Rats were divided into two groups: normal saline control and pantroprazole, which was administered by daily intraperitoneal injections. At 8 weeks postoperative spines were evaluated with manual palpation, microCT, histologic analysis, and biomechanical testing.Results.Fusion rates of the control group and PPI group were not significantly different (100% vs. 94%). Average fusion scores were significantly lower in the pantoprazole group. New bone formation identified on microCT imaging of bilaterally fused specimens demonstrated a lower average volume of newly generated bone in the PPI group, but this difference was not significant. Biomechanical testing demonstrated no significant difference in strength or stiffness of the fusion mass between the groups.Conclusion.This study demonstrates that administration of PPIs does not inhibit fusion rates, bone formation, or affect biomechanical integrity of fusion. However, lower fusion scores in the PPI group suggest that a negative impact may still exist. Future studies will explore growth factor and protein expression in the fusion masses as well as utilize higher doses of PPI to fully discern their effect on spine fusion.Level of Evidence: N/ADespite known negative effects on bone health and bone healing, proton pump inhibitors are commonly prescribed to orthopedic patients for gastrointestinal disorders. Significant rates of pseudarthrosis persist in spine surgery despite advances in techniques and instrumentation. Proton pump inhibitor administration did not negatively affect fusion rates in this rodent model.
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吸烟者和非吸烟者的假关节（手术骨不连）发生率：一项比较研究。
DOI：
--
发表时间：
1986
期刊：
影响因子：
--
作者：
Brown Cw;Orme Tj;Richardson Hd
通讯作者：
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影响因子：
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Wang, Jeffrey C.
影响因子：
3
作者：
Shen, Hong Xing;Buchowski, Jacob M.;Riew, K. Daniel
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Riew, K. Daniel
影响因子：
3.5
作者：
Pombo, Monica;Lame, Michael W.;Tablin, Fern
通讯作者：
Tablin, Fern
影响因子：
5.9
作者：
O'Connell, MB;Madden, DM;Kerzner, LJ
通讯作者：
Kerzner, LJ