Tsai Tsung-Ting, Tai Ching-Lung, Ho Natalie Yi-Ju, Lai Po-Liang, Fu Tsai-Sheng, Niu Chi-Chien, Chen Lih-Huei, Chen Wen-Jer
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Graduate Institute of Medical Mechatronics, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.
PLoS One. 2017 Jan 4;12(1):e0167296. doi: 10.1371/journal.pone.0167296. eCollection 2017.
Osteoporosis is a bone disease that afflicts millions of people around the world, and a variety of spinal integrity issues, such as degenerative spinal stenosis and spondylolisthesis, are frequently concomitant with osteoporosis and are sometimes treated with spinal interbody fusion surgery. Previous studies have demonstrated the efficacy of strontium ranelate (SrR) treatment of osteoporosis in improving bone strength, promoting bone remodeling, and reducing the risk of fractures, but its effects on interbody fusion surgery have not been adequately investigated. SrR-treated rats subjected to interbody fusion surgery exhibited significantly higher lumbar vertebral bone mineral density after 12 weeks of treatment than rats subjected to the same surgery but not treated with SrR. Furthermore, histological and radiographic assessments showed that a greater amount of newly formed bone tissue was present and that better fusion union occurred in the SrR-treated rats than in the untreated rats. Taken together, these results show significant differences in bone mineral density, PINP level, histological score, SrR content and mechanical testing, which demonstrate a relatively moderate effect of SrR treatment on bone strength and remodeling in the specific context of recovery after an interbody fusion surgery, and suggest the potential of SrR treatment as an effective adjunct to spinal interbody fusion surgery for human patients.
骨质疏松症是一种困扰着全球数百万人的骨骼疾病,各种脊柱完整性问题,如退行性腰椎管狭窄症和椎体滑脱,常常与骨质疏松症并发,有时需要通过脊柱椎间融合手术进行治疗。先前的研究已经证明,雷奈酸锶(SrR)治疗骨质疏松症在提高骨强度、促进骨重塑和降低骨折风险方面具有疗效,但其对椎间融合手术的影响尚未得到充分研究。接受椎间融合手术的经SrR治疗的大鼠在治疗12周后,其腰椎骨密度显著高于接受相同手术但未接受SrR治疗的大鼠。此外,组织学和影像学评估显示,与未治疗的大鼠相比,经SrR治疗的大鼠出现了更多新形成的骨组织,并且融合愈合情况更好。综上所述,这些结果表明在骨密度、PINP水平、组织学评分、SrR含量和力学测试方面存在显著差异,这表明在椎间融合手术后的恢复这一特定背景下,SrR治疗对骨强度和重塑具有相对适度的影响,并提示SrR治疗作为人类患者脊柱椎间融合手术有效辅助手段的潜力。