White Klane K, Bawa Maneesh, Ahn Jae-Sung, Farnsworth Christine L, Faro Frances D, Mahar Andrew T, Wedemeyer Michelle, Garfin Steven R, Newton Peter O
Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA.
Spine (Phila Pa 1976). 2005 Jun 15;30(12):1386-95. doi: 10.1097/01.brs.0000166525.79206.31.
Growth factor in a collagen sponge carrier was compared to autograft, both packed within an allograft strut following corpectomy in a bovine spinal model.
To evaluate incorporation of cortical strut allografts after lumbar corpectomy, comparing augmentation with recombinant human bone morphogenetic protein-2 (rhBMP-2) to local autograft.
Autogenous strut grafts are the gold standard for successful fusion in reconstruction following corpectomy; however, significant donor site morbidity can occur. Recent studies describing consistently successful anterior interbody fusions with BMP augmentation suggest an exciting prospect of unlimited and potent grafting material for these difficult fusions.
Sixteen calves underwent L3 corpectomy with instrumented strut allograft reconstruction. The rhBMP-2 impregnated collagen sponges filled the empty medullary canal of the allograft in 8 animals. Eight animals had the allograft strut filled with local autogenous bone. After 4 months, the lumbar spines were harvested for radiographic, biomechanical, and histologic evaluation.
Computerized tomography revealed allograft fusion in 7 of 8 autograft specimens and 8 of 8 BMP specimens. The BMP treated group had denser bone at the ends of the cortical allograft, but a central void persisted. Autograft filled struts maintained a more uniform distribution of less organized bone throughout the strut canal. Histologic assessment verified remodeling and incorporation of the allografts for both groups. Biomechanical testing confirmed no significant difference in fusion strength between groups.
Large cortical strut allografts (after lumbar corpectomy) supplemented with rhBMP-2 had incorporation and fusion strength comparable to allografts enhanced with cancellous autograft.
在牛脊柱模型中，将胶原海绵载体中的生长因子与自体移植骨进行比较，二者均填充于椎体切除术后的同种异体骨支柱内。
评估腰椎椎体切除术后皮质骨支柱同种异体骨的融合情况，比较重组人骨形态发生蛋白-2（rhBMP-2）增强与局部自体移植骨的效果。
自体支柱移植骨是椎体切除术后重建成功融合的金标准；然而，供区会出现明显的并发症。近期关于BMP增强前路椎间融合持续成功的研究表明，对于这些困难的融合手术，有望获得无限且有效的移植材料。
16只小牛接受L3椎体切除术及器械辅助的支柱同种异体骨重建。8只动物的同种异体骨空髓腔内填充rhBMP-2浸渍的胶原海绵。8只动物的同种异体骨支柱填充局部自体骨。4个月后，取出腰椎进行影像学、生物力学和组织学评估。
计算机断层扫描显示，8个自体移植骨标本中有7个、8个BMP标本中有8个实现了同种异体骨融合。BMP治疗组皮质同种异体骨两端的骨密度更高，但中央仍有孔隙。自体骨填充的支柱在整个支柱管内保持了更均匀分布的、组织程度较低的骨。组织学评估证实两组同种异体骨均有重塑和融合。生物力学测试证实两组之间的融合强度无显著差异。
补充rhBMP-2的大型皮质骨支柱同种异体骨（腰椎椎体切除术后）的融合和融合强度与松质骨自体移植骨增强的同种异体骨相当。
