CAJ | 학술논문

目的通过应用正电子发射计算机体层摄影-CT(PET-CT)研究重组人骨形态发生蛋白-2(rhBMP-2)/异体骨复合骨行兔腰椎融合术后不同时间点融合骨组织再血管化程度及成骨活性的变化.方法成年雄性新西兰大白兔45只,随机分为3组,每组15只.在每只兔的L4、L5横突间行腰椎后路植骨融合术,3组分别植入rhBMP-2/异体骨复合骨条(复合骨组)、自体髂骨条(白体骨组)及异体髂骨条(异体骨组),每组于术后2、4、6周注射18F-NaF,利用PET-CT对各组动物进行全身显像,对比各组植骨区摄取值(SUV).结果 2、4、6周时复合骨组和白体骨组植骨区对18F-NaF的SUV均优于异体骨组,差异有统计学意义(P＜0.05);复合骨组植骨区的SUV在4、6周时高于自体骨组,差异有统计学意义(P＜0.05),2周时与自体骨组差异无统计学意义(P＞0.05).同一组内不同时间点复合骨组和白体骨组均在4、6周时局部SUV高于2周时,差异有统计学意义(P＜0.05);4周与6 周之间差异无统计学意义(P＞0.05).异体骨组的SUV 3个时间点问差异均无统计学意义(P＞0.05).结论兔腰椎后路植骨融合术中PET-CT检测显示:rhBMP-2/异体骨复合骨可促进骨形成并改善局部血液供应,可作为替代自体骨的理想材料.
목적 통과응용정전자발사계산궤체층섭영-CT(PET-CT)연구중조인골형태발생단백-2(rhBMP-2)/이체골복합골행토요추융합술후불동시간점융합골조직재혈관화정도급성골활성적변화.방법 성년웅성신서란대백토45지,수궤분위3조,매조15지.재매지토적L4、L5횡돌간행요추후로식골융합술,3조분별식입rhBMP-2/이체골복합골조(복합골조)、자체가골조(백체골조)급이체가골조(이체골조),매조우술후2、4、6주주사18F-NaF,이용PET-CT대각조동물진행전신현상,대비각조식골구섭취치(SUV).결과 2、4、6주시복합골조화백체골조식골구대18F-NaF적SUV균우우이체골조,차이유통계학의의(P＜0.05);복합골조식골구적SUV재4、6주시고우자체골조,차이유통계학의의(P＜0.05),2주시여자체골조차이무통계학의의(P＞0.05).동일조내불동시간점복합골조화백체골조균재4、6주시국부SUV고우2주시,차이유통계학의의(P＜0.05);4주여6 주지간차이무통계학의의(P＞0.05).이체골조적SUV 3개시간점문차이균무통계학의의(P＞0.05).결론 토요추후로식골융합술중PET-CT검측현시:rhBMP-2/이체골복합골가촉진골형성병개선국부혈액공응,가작위체대자체골적이상재료.
Objective To investigate revascularization and osteogenesis of the fusion masses in rabbits undergoing posterolateral lumbar spinal fusion with recombinant human bone morphogenetic protein-2 (rhBMP-2)/allograft composite. Methods Forty-five adult male New Zealand white rabbits were randomly divided into 3 even groups. The rabbits in each group undergoing intertransverse process fusion at L4 and L5 respectively with rhBMP-2/allograft composite (group A), autograft (group B) and allograft (group C). 18F-NaF was injected into every rat at 2nd, 4th and 6th weeks after surgery. Whole-body radionuclide scan by PET-CT was done for all rats to evaluate the uptake values (SU V) in fusion areas. Results The SUVs for autograft and composite groups were superior to that for allograft group at 2nd, 4th and 6th weeks ( P ＜0. 05). The SUV for composite group was significantly higher than that for autograft group at the 4th and 6th weeks ( P ＜0. 05), but similar to that for autograft group at the 2nd week ( P ＞ 0. 05) . Conclusion Since the rhBMP-2/allograft composite can not only promote the bone formation but also improve the blood supply in the posterolateral lumbar spinal fusion, it may serve as a substitute material for autografts.