Yee Albert Juang Ming, Bae Hyun W, Friess Darin, Roth Sandie M, Whyne Cari, Robbin Mark, Johnstone Brian, Yoo Jung U
Spine Institute, University Hospitals of Cleveland and Department of Orthopaedic Surgery, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Spine J. 2006 Jul-Aug;6(4):391-6. doi: 10.1016/j.spinee.2005.10.017.
There has been recent enthusiasm regarding the potential positive effects of statins on bone. Statins vary in their ability to influence bone activity. Simvastatin has been shown in experimental models to stimulate bone acting growth factors and enhance bone formation.
The potential efficacy of Simvastatin in enhancing spinal fusion was evaluated in a rabbit posterolateral intertransverse process fusion model.
STUDY DESIGN/SETTING: Posterior lumbar intertransverse process spinal fusion performed on New Zealand White rabbits. PATIENT/STUDY SAMPLE: 44 New Zealand White rabbits.
Spinal fusion as determined by manual palpation testing and fine detail radiography. Bone fusion mass volume and density as determined by CT scan imaging.
Forty-four New Zealand White rabbits underwent posterolateral intertransverse process spine fusion using autogenous iliac crest bone graft. Simvastatin was administered orally in 20 animals and the serum lipid profile quantified in test and control animals. The animals were euthanized 9 weeks following index surgery and the lumbar spine was harvested. Spinal fusion was determined by manual palpation testing and fine detail radiography. The volume and density of the bone fusion mass was quantified by computed tomography.
Drug treatment for 9 weeks caused a reduction in serum lipid biochemical markers when compared with controls. The spinal fusion rate, as judged by manual palpation testing (13.0% control group, 16.6% Simvastatin group) and fine detail radiography, was not significantly different comparing treatment with control animals. Accordant with the assessment of spinal fusion, there was no statistically significant effect on the volume of the fusion mass (1,224.7+/-98.7 mm(3) in the control group and 1,075.9+/-66.3 mm(3) in the Simvastatin group), the density of bone in the lumbar spine or that in the formed fusion mass.
Systemic use of Simvastatin caused a reduction in lipid biochemical parameters in treated animals. Successful spinal fusion as judged by manual palpation testing and fine detail radiography was not significantly different in treated versus untreated animals. The bone volume density of the formed fusion mass was not significantly different in treated versus untreated animals. There did not appear to be a significant advantage or disadvantage to the use of Simvastatin rabbit posterolateral spinal fusion. The potential positive effects of statins on bone require further study.
近期，人们对他汀类药物对骨骼的潜在积极作用充满热情。不同他汀类药物影响骨骼活性的能力各异。在实验模型中，辛伐他汀已被证明可刺激骨生长因子并增强骨形成。
在兔后外侧横突间融合模型中评估辛伐他汀增强脊柱融合的潜在疗效。
研究设计/场所：对新西兰白兔进行后外侧腰椎横突间脊柱融合术。
患者/研究样本：44只新西兰白兔。
通过手动触诊测试和精细X线摄影确定脊柱融合情况。通过CT扫描成像确定骨融合块的体积和密度。
44只新西兰白兔采用自体髂骨移植进行后外侧横突间脊柱融合术。20只动物口服辛伐他汀，并对试验组和对照组动物的血脂谱进行定量分析。在初次手术后9周对动物实施安乐死，并取出腰椎。通过手动触诊测试和精细X线摄影确定脊柱融合情况。通过计算机断层扫描对骨融合块的体积和密度进行定量分析。
与对照组相比，药物治疗9周后血清脂质生化标志物有所降低。通过手动触诊测试（对照组为13.0%，辛伐他汀组为16.6%）和精细X线摄影判断，治疗组与对照组动物的脊柱融合率无显著差异。与脊柱融合评估结果一致，对融合块体积（对照组为1224.7±98.7立方毫米，辛伐他汀组为1075.9±66.3立方毫米）、腰椎骨密度或形成的融合块骨密度均无统计学显著影响。
全身使用辛伐他汀可使治疗动物的脂质生化参数降低。通过手动触诊测试和精细X线摄影判断，治疗组与未治疗组动物的脊柱融合成功率无显著差异。治疗组与未治疗组动物形成的融合块骨体积密度无显著差异。在兔后外侧脊柱融合中使用辛伐他汀似乎没有明显优势或劣势。他汀类药物对骨骼的潜在积极作用需要进一步研究。
