目的 探讨富血小板血浆(PRP)复合填充异体松质骨的骨笼(Cage),重建颈椎的能力.方法 取26只新西兰大耳白兔切除一个颈椎制成颈椎缺损模型并分为两组,A组植入PRP-Cage复合物,B组植入自体髂骨,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、生物力学测试,比较两者促进颈椎融合重建颈椎的能力,应用SSPS 13.0软件进行分析.结果 术后2个月X线片及大体标本观察示两组植骨部位形成大量骨痂,与邻近椎体融合.组织学观察术后1个月两组均可见有散在骨岛及骨小梁形成;2个月两组均形成大量成熟骨基质,骨小梁及骨髓腔.扫描电镜观察示两组有大量新骨及成骨细胞形成.2个月生物力学测试在50 N载荷下屈曲、伸展载荷-应变变化平均值A为52.33±3.10、42.63±2.80,B组53.98±3.80、47.23±2.30,两组比较差异无统计学意义(t=0.583、2.199,P>0.05).结论 PRP复合异体Cage具有较强的成骨能力及生物学稳定性,PRP中的多种生长因子可能调节及改善组织细胞功能和微环境,产生骨诱导促进椎间融合.
Objective To explore the ability of reconstructing cervical vertebrae of platelet-rich plasma (PRP) and CAGE with the compound of humeral cortical ring allograft (HCA) packed with cancellous allogenic bone (CALB),and find some evidence to support the clinical practice of PRP-CAGE complex on reconstruction of vertebral body.Methods The animal models of a cervical vertebrae defect were created by surgery in 26 New Zealand white rabbits.The A group were treated with the compound of PRP-CAGE;the B group with autogenous iliac crest.Observations were made by gross,X-ray,histopathological,scanning electron microscope (SEM) examination and the effect were determined by biomechanics at different periods postoperatively.Statistical methods is t Test,there was significant difference in statistics (P < 0.05).Results The gross and X-ray examination showed that spine fusion in A and B group 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 and osteoblast formed in tow groups.The flexion values on the tests of the 50 N load-strain in flexion,extension were 52.33 ± 3.10,53.98 ± 3.80 in 2 groups,The extension values were 42.63 ± 2.80,47.23 ± 2.30 in 2 groups.The effect of biomechanics had no statistically in tow groups (t =0.583,2.199,P>0.05).Conclusion The compound of PRP-Cage possesses much high bone inductive potentialities and biomechanic stability.PRP may be associated with the role of multiple growth factors in regulating cell function,improving the tissue microenvironment,and promoting intervertebral fusion.