spinal reconstruction using recombinant human bone morphogenic protein after total spondylectomy

20只狗接受TI3全椎突切除术和钛网笼脊柱重建，采用同种骨移植（切除的椎体）和重组人骨形态发生蛋白-2（rhBMP-2）评估骨重塑和融合。对照组（同种骨移植物n=10）：用自体骨填充钛笼重建，bmp处理组（n=10）：用bmp -2浸泡的钛笼填充胶原海绵重建。分别于术后8周（A组）和16周（B组）处死5只狗，通过影像学检查（Xp、CT扫描）和组织学检查评估骨重塑和融合情况。影像学检查显示，除了对照组的一个假关节外，所有标本的骨融合。组织学检查显示，A组5只犬中有4只犬从相邻椎体终板向笼中心方向的骨小梁形成板正常，笼中心周围出现编织骨。它被认为是一种重塑的过程。另一只狗有假关节。对照组B 5只犬中有3只相邻椎体间实现了连续的骨小梁松质骨融合。与对照组a相比，另外两组的骨融合向补片中心方向进展，认为骨融合将继续进展。在bmp处理的A组，骨向补片中心进行性形成。B组5只犬均实现了移植物骨与相邻椎体间连续的骨小梁松质骨融合。两组均有良好的骨融合，但bmp处理组在整个补片长度上的骨小梁形成比对照组多。本研究证实了rhBMP2在全椎切除后椎体重建中增强骨融合和重塑。

20 Dogs underwent total spondylectomy of TI3 and spinal reconstruction with titanium mesh cage using autogeneous bone graft(resected vertebral body) and recombinant human bone morphogenetic protein-2(rhBMP-2) to evaluate bone remodeling and fusion.Control group(autogeneous bone graft n=10):had the titanium cage reconstruction filled with autogenous bone, and BMP-treated group(n=10):had reconstruction with the titanium cage filled collagen sponge soaked with rhBMP-2. 5 dogs of each group were killed 8weeks(group A) and 16 weeks(group B) after the surgery and we evaluated bone remodeling and fusion by imaging test(Xp, CT scan) and histologic examination.Imaging test revealed bone fusion in all specimens with the exception of one pseudoarthrosis in the control group. Histologic examination showed 4 of 5 dogs in control group A had normal lamella of trabecular bone formation from the endplate of the adjacent vertebral bodies towards the center of the cage, and woven bone was present around the center of cage. It is considered to be a progress of remodeling. The other one dog had pseudoarthrosis. 3 of 5 dogs in control group B achieved consecutive trabecular cancellous bony fusion between adjacent vertebral bodies. The other two had more progressive abone formation towards the center of the mesh compared to the control group A. It is considered that bone fusion is going to be progressed.In BMP-treated group A, there were progressive bone formation towards the center of the mesh. All the 5 dogs in BMP-treated group B achieved consecutive trabecular cancellous bony fusion between the grafted bone and adjacent vertebral bodies.Both groups could have favorable bone fusion, but BMP-treated group had more trabecular bone formation throughout the length of the mesh than control group.This study confirms rhBMP2 augment bony fusion and remodeling on vertebral reconstruction after total spondylectomy.