CAJ | 학술논문

背景：现如今关于组织工程骨的相关研究大多集中在骨干临界性骨缺损方面，关于其在脊柱融合中的相关研究和报道相对较少。目的：探讨在脊柱横突间融合治疗中异种脱蛋白松质骨作为骨组织工程支架的应用可行性。方法：取成年猪股骨远端松质部分，制备异种脱蛋白松质骨材料，与重组人骨形态发生蛋白复合后，再复合骨髓间充质干细胞制备组织工程骨。取24只山羊，制备横突间植骨床，随机均分为2组，观察组左侧植入组织工程骨，右侧植入载重组人骨形态发生蛋白的异种脱蛋白松质骨；对照组左侧植入自体髂骨，右侧植入异种脱蛋白松质骨。植入后4，8，12周获取融合节段，进行大体观察、X射线观察、组织学观察及生物力学检测。结果与结论：X 射线显示，两组植入材料均固定良好，固定效果可靠。植入后不同时间点，各组植入材料均处于良好位置，材料周围组织未出现化脓或者坏死等，且均出现软组织长入、包裹，植入材料周围均未出现积液和坏死等，其中组织工程骨组影像学表现与组织学表现优于载重组人骨形态发生蛋白异种脱蛋白松质骨组、异种脱蛋白松质骨组，与自体骨最接近。植入后12周，组织工程骨组最大弯曲载荷最接近自体髂骨组，两组间比较差异无显著性意义。表明在脊柱横突间融合治疗中，异种脱蛋白松质骨作为骨组织工程支架具有一定的应用可行性。
배경：현여금관우조직공정골적상관연구대다집중재골간림계성골결손방면，관우기재척주융합중적상관연구화보도상대교소。목적：탐토재척주횡돌간융합치료중이충탈단백송질골작위골조직공정지가적응용가행성。방법：취성년저고골원단송질부분，제비이충탈단백송질골재료，여중조인골형태발생단백복합후，재복합골수간충질간세포제비조직공정골。취24지산양，제비횡돌간식골상，수궤균분위2조，관찰조좌측식입조직공정골，우측식입재중조인골형태발생단백적이충탈단백송질골；대조조좌측식입자체가골，우측식입이충탈단백송질골。식입후4，8，12주획취융합절단，진행대체관찰、X사선관찰、조직학관찰급생물역학검측。결과여결론：X 사선현시，량조식입재료균고정량호，고정효과가고。식입후불동시간점，각조식입재료균처우량호위치，재료주위조직미출현화농혹자배사등，차균출현연조직장입、포과，식입재료주위균미출현적액화배사등，기중조직공정골조영상학표현여조직학표현우우재중조인골형태발생단백이충탈단백송질골조、이충탈단백송질골조，여자체골최접근。식입후12주，조직공정골조최대만곡재하최접근자체가골조，량조간비교차이무현저성의의。표명재척주횡돌간융합치료중，이충탈단백송질골작위골조직공정지가구유일정적응용가행성。
BACKGROUND:Nowadays, most of the studies regarding tissue engineering bone have mostly focused on critical-size bone defects of the backbone; however, there are less studies and reports on its spinal fusion. OBJECTIVE:To explore the feasibility of xenogeneic deproteinized cancelous bone as bone tissue engineering scaffold in the treatment of spinal intertransverse fusion. METHODS:The cancelous part in the distal femur of adult pigs was obtained to prepare xenogeneic deproteinized cancelous bone. After combined with the recombinant human bone morphogenetic protein, the xenogeneic deproteinized cancelous bone was combined with bone marrow mesenchymal stem cels to prepare tissue engineering bone. Twenty-four goats were obtained to prepare intertransverse bone bed, and randomly divided into two groups: observation and control groups. In the observation group, the tissue engineered bone was implanted into the left side, and the xenogeneic deproteinized cancelous bone of recombinant human bone morphogenetic protein was implanted into the right side. In the control group, the autologous iliac bone was implanted into the left side, and xenogenic deproteinization cancelous bone was implanted into the right side. At the 4th, 8th and 12th weeks after implantation, the fusion segment was obtained for gross observation, X-ray observation, histological observation and biomechanical testing. RESULTS AND CONCLUSION:X-ray films showed that the implant materials from these two groups were fixed wel and reliably. At different time points after implantation, the implant materials from each group were al in good position. There were no purulent and necrotic tissues around the material. Soft tissue ingrow and wraping were present. There were no effusions and necrosis surrounding the implant materials. The imaging and histological performance in the tissue engineering bone group outperformed that in the recombinant human bone morphogenetic protein xenogenic deproteinized cancelous bone group and xenogenic deproteinized cancelous bone group, which was the most close to the autogenous bone. At the 12th week after implantation, the maximum bending load in the tissue engineering bone group was the most close to the autogenous iliac bone group. There was no significant difference between these two groups. These results demonstrate that as bone tissue engineering scaffold, xenogenic deproteinized cancelous bone has a certain application feasibility in the treatment of spinal intertransverse fusion.