CAJ | 학술논문

目的研制丝素蛋白(SF)/双相磷酸钙(BCP)/半水硫酸钙(CSH)/重组人骨形态发生蛋白-2(rhBMP-2)骨水泥,并探讨其在绵羊椎体内的成骨作用. 方法制备SF/BCP/CSH/rhBMP-2骨水泥,分别在12只绵羊的L2 L3、L4椎体内制作直径为6.0mm、深度为10 mm的圆柱型骨缺损模型,在3个缺损处随机植入SF/BCP/CSH/rhBMP-2骨水泥作为实验组,植入聚甲基丙烯酸甲酯(PMMP)作为对照组,另一椎体缺损处不植入任何材料作为空白对照组.术后3、6个月分别随机处死6只绵羊进行CT、组织学和生物力学检查.结果 CT和组织学检查显示:术后3个月实验组椎体密度与正常椎体相似,骨缺损修复基本完成,术后6个月骨缺损修复完成;对照组术后3、6个月时PMMP无降解,并与骨之间结合疏松,表面无新骨形成;空白对照组术后3、6个月时骨缺损一直存在.生物力学测试显示:术后3、6个月时实验组椎体抗压强度和刚度与正常椎体相比差异无统计学意义(P＞0.05). 结论 SF/BCP/CSH/rhBMP-2骨水泥具有良好的成骨作用,在成骨过程中能维持椎体的力学性能,有望成为经皮椎体强化术的一种可降解、具成骨作用的填充剂.
목적 연제사소단백(SF)/쌍상린산개(BCP)/반수류산개(CSH)/중조인골형태발생단백-2(rhBMP-2)골수니,병탐토기재면양추체내적성골작용. 방법 제비SF/BCP/CSH/rhBMP-2골수니,분별재12지면양적L2 L3、L4추체내제작직경위6.0mm、심도위10 mm적원주형골결손모형,재3개결손처수궤식입SF/BCP/CSH/rhBMP-2골수니작위실험조,식입취갑기병희산갑지(PMMP)작위대조조,령일추체결손처불식입임하재료작위공백대조조.술후3、6개월분별수궤처사6지면양진행CT、조직학화생물역학검사.결과 CT화조직학검사현시:술후3개월실험조추체밀도여정상추체상사,골결손수복기본완성,술후6개월골결손수복완성;대조조술후3、6개월시PMMP무강해,병여골지간결합소송,표면무신골형성;공백대조조술후3、6개월시골결손일직존재.생물역학측시현시:술후3、6개월시실험조추체항압강도화강도여정상추체상비차이무통계학의의(P＞0.05). 결론 SF/BCP/CSH/rhBMP-2골수니구유량호적성골작용,재성골과정중능유지추체적역학성능,유망성위경피추체강화술적일충가강해、구성골작용적전충제.
Objective To prepare compound bone cement of silk fibroin/biphasic calcium phosphate/alpha-calcium sulphate hemihydrate/recombinant human bone morphogenetic protein-2 (SF/BCP/CSH/rhBMP-2) and to study its osteogenesis capacity for sheep vertebral defects.Methods Compound bone cement SF/BCP/CSH/rhBMP-2 was prepared and a cylindrical bone defect (6.0 mm in diameter and 10 mm in depth) was created at lumbar vertebrae 2,3 and 4 by open operation in 12 sheep.The injured lumbar vertebrae in each sheep were randomly divided into 3 study groups.The experimental group was implanted with the SF/BCP/CSH/rhBMP-2,the control group with polymethylmethacrylate (PMMA),and the blank control group with nothing.At 3 and 6 months postoperation,6 random sheep were sacrificed for radiological,histological and biomechanical tests to check the reparation of sheep vertebral defects.Results Radiological and histological examinations showed that the vertebral bone density in the experimental group was similar to that of a normal vertebral body and the bone defects were almost repaired at 3 months postoperation and completely repaired at 6 months postoperation.Loose union between the bone and PMMA was observed but no degradation of PMMA or no formation of new bone was observed in the control group at 3 and 6 months postoperatively.The bone defects in the blank control group were not repaired at either time points.Biomechanical tests showed that there were no statistically significant differences between the experimental group and normal vertebral bodies regarding compressive strength and rigidity at 3 and 6 months postoperatively.Conclusion SF/BCP/CSH/rhBMP-2 may become a biodegradable vertebral filler with osteogenesis for percutaneous vertebroplasty and kyphoplasty because it possesses a good capability of repairing vertebral bone defects and maintaining mechanical properties of a vertebral body in the process of bone formation.