【摘要】 目的:探讨同种异体皮质骨环(HCA)、自体红骨髓(RBM)及异体松质骨(CAB)复合骨重建颈椎的能力,为临床应用提供理论依据。方法:取39只新西兰大耳白兔,切除第4颈椎制成椎体缺损模型并分为3组,A组植入HCA-RBM-CAB复合物,B组植入自体髂骨,C组植入HCA-RBM-丙烯酸树脂骨水泥(acrylicbonece-ment,ABC),在术后不同时间分别进行大体标本、组织学、X线片、扫描电镜观察,并行生物力学测试,比较三者修复骨缺损的能力。结果:术后2个月X线片及大体标本观察,A组与B组植骨材料与上下颈椎融合,有大量骨痂;C组未完全融合,只有少量骨痂生长;组织学观察示术后1个月A组与B组可见有散在骨岛及骨小梁形成,C组仅可见少量新骨及软骨岛形成,2个月时A组与B组形成大量成熟骨基质、骨小梁及骨髓腔,C组仅有少量编织骨形成,骨细胞不成熟,未形成骨髓腔。术后2个月扫描电镜观察示A组有大量新骨形成。2个月时生物力学测试结果表明A组与B组力学指标无显著性差异(P>0.05),A、B组与C组比较有显著性差异(P<0.01)。结论:HCA-RBM-CAB复合物具有较强的成骨能力及生物力学稳定性,可作为有效的椎体重建材料。更多还原

【Abstract】 Objective:To explore the potential of reconstruction of cervical vertebrae with the compound humeral cortical ring allograft(HCA)packed with red bone morrow(RBM)and cancellous allogenic bone(CAB),and find some evidence for the clinical practice of allogenic composite implants on reconstruction of vertebral body.Method:The animal models of the fouth cervical vertebrae defect were created in the New Zealand white rabbits.Group A were implanted with the compound of HCA,RBM and CAB,group B with autogenous iliac crest,group C with HCA,RBM and acrylic bone cement.All specimens were analysed by gross,X-ray,histopathological and scanning electron microscope(SEM)examination,the biomechanical effect were determined at different stage postoperatively.Result:The effect of biomechanics had no statistically significance difference between group A and B.The effect of biomechanics in group A and B was lower than that in group C.The gross and X-ray showed spinal fusion in group A and B at 2 months.Histological analysis exhibited scattered bone island and bone trabecula formation at 1 month,many mature bone matrix and bone marrow cavity formation at 2 months,the SEM also showed that there were many new bone formation in group A at 2 months.Conclusion:The compound of HCA,RBM and CAB possesses much higher bone inductive potentialities and biomechanical stability in reconstruting vertebrae.更多还原