【摘要】 目的:通过对老年和青年兔采用基因重组人骨形态发生蛋白2(rhBMP2)和自体骨移植进行腰椎后外侧横突间融合手术实验研究,揭示rhBMP2在老年动物脊柱融合中的作用效果。方法:采用24只雌性新西兰大白兔,体重3.5～4.5kg,6月龄(青年)和24月龄(老年)各12只。随机分成4组:①青年自体髂骨移植组[ICBG(Y),6只];②青年rhBMP2组[rhBMP2(Y),6只];③老年自体髂骨移植组[ICBG(O),6只];④老年rhBMP2组[rhBMP2(O),6只]。同一天施行腰椎后外侧横突间融合术。rhBMP2和自体髂骨分别植入两侧L5-L6横突间。术后3、6周分别处死一半。结果采用手动触诊,X线摄片,CT三维扫描和组织学评估。结果:X线片及三维CT显示rhBMP2组的融合率均高于自体髂骨移植组,而青年各组融合率比老年组高,各组之间比较差异具有统计学意义(P<0.05)。CT三维重建显示由于rhBMP2是液态,有流动性,成骨范围较大,不局限于计划融合区。组织学显示老年rhBMP2组成骨面积较青年rhBMP2组小,而且骨小梁结构也不如后者密集。结论:与自体髂骨移植比较,rhBMP2可显著增强老年兔脊柱后外侧融合率和新骨生成量,加快融合时间,可以取代自体髂骨移植。rhBMP2促进骨再生能力受年龄影响。更多还原

【Abstract】 Objective:Posterolateral intertransverse process fusion was performed in aged and young adult female rabbits lumbar spine using recombinant human bone morphogenetic protein 2(rhBMP 2 ) and autograft to reveal the function of rhBMP 2 on spinal fusion on aged animals.Methods:A total of 24 female New Zealand white rabbits included 12 young adult of 6 months and 12 aged of 2 year old,was divided into 4 groups:①young adult autologous iliac crest bone groupICBG(Y),n=6);②young adult rhBMP 2 / absorbable collagen sponge(ACS) groupBMP 2(Y),n=6;③aged autologous iliac crest bone groupICBG(O),n=6;④aged rhBMP 2 / ACS groupBMP 2(O),n=6.All were underwent posterolateral fusion in same day.rhBMP 2 and autologous iliac crest bone was implant bilateral L5-L6 intertransverse processes,respectively.Half of the rabbits were sacrificed at 3,6 weeks following surgery,respectively.The results were assessed by manual palpation,radiographs,computed tomographic scans(3D) and histology.Results:Six weeks after surgery,radiography,computed tomography and histology indicated the different result in healing in the posterolateral fusion using rhBMP 2 compared to ICBG(P<0.05).Aged BMP 2 group showed significantly higher fusion rates than Aged ICBG group.Conclusion:This study demonstrated rhBMP 2 can increase the posterolateral fusion rate and new bone quality in aged rabbitss than autograft,it may take the place of ICBG.But its role is effected by age.更多还原