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经皮椎体成形术后骨水泥与骨界面的相关生物学研究。

Related Biological Research in the Interface between Bone Cement and Bone after Percutaneous Vertebroplasty.

机构信息

Department of Spine Surgery, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing 400016, China.

出版信息

Int J Endocrinol. 2013;2013:109784. doi: 10.1155/2013/109784. Epub 2013 Oct 3.

Abstract

Percutaneous vertebroplasty (PVP) is widely used in the treatment of painful osteoporotic vertebral compression fractures with the injection of PMMA cement, and the controversy for PMMA damage to the osteoporotic bone tissue and to affect the fractures repairing never stops. 72 old female rabbits, each age 3.0~3.5 y, rabbits were assigned randomly to two groups of thirty-six each; PMMA cement were injected into vertebral body in rabbits via mimic PVP, sacrificed at 1 h, 24 h, 3 d, 7 d, 4 w, and 12 w. The expression VEGF and collagen type I, the tissue response, and repair reaction in the interface between PMMA and bone tissue were observed dynamically with RT-PCR and western blot technique; the osteocalcin expression were studied by immunohistochemistry. Compared with the control group, the expression of collagen I increased at 1 hour and was higher from 24 h to 3 d. From 4 weeks to 12 weeks after injection of PMMA. The expression of VEGF decreased at 1 hour and 24 hours, significantly increased at 3 days, decreased once again at 7 days, then increased significantly at 4-12 weeks. The osteocalcin expression continued to increase during 4 to 12 week. PMMA would not cause local bone permanent necrosis, and interface injury repairing cycle could be prolonged in a vertebroplasty.

摘要

经皮椎体成形术(PVP)广泛应用于治疗疼痛性骨质疏松性椎体压缩骨折,通过注射 PMMA 水泥进行治疗,而 PMMA 对骨质疏松性骨组织的损害以及对骨折修复的影响的争议从未停止过。72 只 3.0~3.5 岁的老年雌性兔子,随机分为两组,每组 36 只;通过模拟 PVP 将 PMMA 水泥注入兔椎体,分别于 1 h、24 h、3 d、7 d、4 w 和 12 w 处死。采用 RT-PCR 和 Western blot 技术动态观察 PMMA 与骨组织界面的 VEGF 和胶原 I 表达、组织反应和修复反应;用免疫组织化学法研究骨钙素的表达。与对照组相比,胶原 I 的表达在 1 小时时增加,从 24 小时到 3 天增加更高。PMMA 注射后 4 周至 12 周,VEGF 的表达在 1 小时和 24 小时时降低,在 3 天时显著增加,在 7 天时再次降低,然后在 4-12 周时显著增加。骨钙素的表达在 4 至 12 周内持续增加。PMMA 不会导致局部骨永久坏死,并且在椎体成形术中可以延长界面损伤修复周期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6944/3814054/e67c37726bff/IJE2013-109784.001.jpg

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