异种冻干骨复合自体骨髓行兔脊柱融合术的实验研究

发布时间：2018-11-09 17:19

【摘要】：目的:采用复合自体骨髓的异种冻干骨行兔腰椎横突间植骨融合手术,从影像学、组织学等方面检测融合效果,从而提供一种效果优良、来源充足的脊柱植骨融合材料。方法:将36只兔子随机平均分为3组,A组(12只):异种冻干骨混合自身骨髓,B组(12只):单纯异种冻干骨,C组(12只):自体髂骨,将植骨材料植入各自组别的模型横突间。术后12周处死模型,收集并处理好标本,分别采用大体观察、影像学、组织学、生物力学检测等观察、分析融合成效。结果:术后12周,从大体观察、手动检查上比较,A、C两组的融合率高于B组且有统计学差异(p0.05)。影像学检查根据Curylo分级评分A、C两组的融合率高于B组,有显著性差异。生物力学检测植骨区标本承受三点弯曲载荷时,单纯异种冻干骨组的最大弯曲三点破坏平均载荷为184.32±31.07N,自体髂骨移植组的最大弯曲三点破坏平均载荷为304.29±18.36N,异种冻干骨复合自体骨髓组的最大弯曲三点破坏平均载荷为252.47±25.45N,B组的抗弯曲硬度明显低于A、C两组,统计学分析有差异(p0.05),而A组与C组在统计学上无差异(p0.05)。组织学上,A组可见大量成骨细胞生成,植骨材料内可见成熟的骨细胞;B组只有少量成骨细胞形成;C组可见新生的骨小梁形成。结论:复合自体骨髓的异种冻干骨可有效的提高脊柱融合效果,与自体髂骨移植无明显差异,可以作为脊柱融合手术的植骨材料选择之一。
[Abstract]:Objective: to evaluate the fusion effect of intertransverse bone graft of lumbar vertebrae in rabbits with allogeneic freeze-dried bone marrow combined with autologous bone marrow, and to provide a good and abundant material for spinal graft fusion. Methods: Thirty-six rabbits were randomly divided into three groups: group A (n = 12), group B (n = 12), group C (n = 12): autogenous iliac bone, group B (n = 12): allogeneic freeze-dried bone, group C (n = 12): autogenous iliac bone, group B (n = 12). Bone graft materials were implanted into the transverse process of each group. 12 weeks after operation, the models were sacrificed and the specimens were collected and processed. The fusion effect was analyzed by observing gross observation, imaging, histology, biomechanical examination and so on. Results: at 12 weeks after operation, the fusion rate of group A and C was higher than that of group B by gross observation and manual examination (p0.05). The fusion rate of group A and C was higher than that of group B according to Curylo score, and there was a significant difference between the two groups. Biomechanical analysis showed that the mean load of maximum bending three point failure was 184.32 卤31.07Nin the xenogeneic freeze-dried bone group and 304.29 卤18.36Nin the autogenous iliac bone graft group. The mean bending hardness of group B was significantly lower than that of group A (252.47 卤25.45 NM), which was significantly lower than that of group A (p 0.05), and the mean load of maximum bending three-point failure in group B was significantly lower than that in group A (P < 0.05). There was no statistical difference between group A and group C (p0.05). Histologically, a large number of osteoblasts were found in group A, mature bone cells were found in bone graft materials, only a few osteoblasts were formed in group B, and new trabeculae formation was observed in group C. Conclusion: allogeneic freeze-dried bone combined with autologous bone marrow can effectively improve the effect of spinal fusion, and there is no significant difference with autogenous iliac bone graft. It can be used as a choice of bone graft materials for spinal fusion surgery.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.34

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