Lawrence James P, Ennis Frank, White Andrew P, Magit David, Polzhofer Gert, Drespe Inneke, Troiano Nancy W, Grauer Jonathan N
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.
Spine J. 2006 Jul-Aug;6(4):385-90. doi: 10.1016/j.spinee.2005.10.010.
Despite numerous studies evaluating the anabolic effects of intermittent administration of parathyroid hormone (PTH) on bone, there are no published studies examining its effect on spinal fusion outcomes.
To determine the effect of daily injection of human recombinant PTH(1-34) on posterolateral lumbar fusions in a rat model.
Prospective, case-controlled, preclinical animal study.
Manual palpation and serum osteocalcin.
Single-level, intertransverse process spinal fusions were performed with iliac crest autograft in 56 Sprague-Dawley rats. Animals received daily injections of placebo or PTH(1-34). At 6 weeks, fusion masses were assessed by manual palpation. Serum osteocalcin levels were assessed in a subset of the animals.
Manual palpation revealed the control group to have a fusion rate of 37% (10/27) and the PTH(1-34)-treated group to have a fusion rate of 52% (15/29). Mean serum osteocalcin levels were 59.8 and 88.6 ng/L for the control and PTH(1-34) groups, respectively.
There was a trend towards greater fusion rate in the PTH(1-34) group as compared with the placebo group. Further, PTH(1-34) administration was associated with a significant increase in osteocalcin levels. Certainly, further investigations are warranted, as an injectable agent capable of increasing fusion rates would be of great clinical value.
尽管有大量研究评估间歇性给予甲状旁腺激素（PTH）对骨骼的合成代谢作用，但尚无已发表的研究探讨其对脊柱融合结果的影响。
确定每日注射人重组PTH（1-34）对大鼠模型后外侧腰椎融合的影响。
前瞻性、病例对照、临床前动物研究。
手法触诊和血清骨钙素。
对56只Sprague-Dawley大鼠进行单节段横突间脊柱融合术，并植入自体髂骨移植。动物每日接受安慰剂或PTH（1-34）注射。6周时，通过手法触诊评估融合块情况。在一部分动物中评估血清骨钙素水平。
手法触诊显示，对照组融合率为37%（10/27），PTH（1-34）治疗组融合率为52%（15/29）。对照组和PTH（1-34）组的平均血清骨钙素水平分别为59.8 ng/L和88.6 ng/L。
与安慰剂组相比，PTH（1-34）组有更高融合率的趋势。此外，给予PTH（1-34）与骨钙素水平显著升高相关。当然，由于一种能够提高融合率的注射剂将具有巨大的临床价值，因此有必要进行进一步的研究。
