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使用自体冷冻骨进行脊柱重建的组织学检查。

A histological examination of spinal reconstruction using a frozen bone autograft.

作者信息

Shinmura Kazuya, Murakami Hideki, Demura Satoru, Kato Satoshi, Yoshioka Katsuhito, Hayashi Hiroyuki, Inoue Kei, Ota Takashi, Yokogawa Noriaki, Ishii Takayoshi, Igarashi Takashi, Tsuchiya Hiroyuki

机构信息

Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Japan.

出版信息

PLoS One. 2018 Jan 25;13(1):e0191679. doi: 10.1371/journal.pone.0191679. eCollection 2018.

Abstract

Our aim was to compare the process of bone formation after reconstruction of the vertebral body using a titanium cage with either a liquid nitrogen-treated (frozen) bone autograft or non-treated fresh bone autograft. Twelve canine beagles underwent anterior reconstruction of the 5th lumbar vertebrae using a titanium cage and bone autograft. Bone formation was compared across four experimental groups: fresh bone autograft groups, with animals sacrificed at either 8 or 16 weeks post-reconstruction, and liquid nitrogen-treated (frozen) bone autograft groups, with animals again sacrificed at either 8 or 16 weeks post-reconstruction. Bone formation was evaluated histologically by calculating the proportion of 'reaction' and 'mature bone' regions at the ends of the cage, its center, and ventral/dorsal sides. The reaction region contained osteocytes with a nucleus and osteoblasts accumulated on the surface of an osteoid, while a laminar structure was visible for mature bone regions. For fresh bone autografts, the reaction and mature bone regions significantly increased from 8 to 16 weeks post-reconstruction. By comparison, for frozen autografts, the reaction bone region did not significantly increase from 8 to 16 weeks post-reconstruction, while the mature bone region did increase over this time period. The proportion of reaction bone was higher at the ends and dorsal side of the cage at 8 weeks, for both graft types, with greater bone formation at the center of the cage at 16 weeks only for the fresh bone autograft. Therefore, bone formation in the anterior spinal reconstruction site tended to be delayed when using a frozen bone autograft compared to a fresh bone autograft. The bone formation process, however, was similar for both groups, beginning at the ends and dorsal side of the cage adjacent to the surrounding vertebral bone.

摘要

我们的目的是比较使用钛笼并植入液氮处理(冷冻)的自体骨移植或未处理的新鲜自体骨移植重建椎体后骨形成的过程。12只比格犬接受了使用钛笼和自体骨移植对第5腰椎进行前路重建。在四个实验组中比较骨形成情况:新鲜自体骨移植组,分别在重建后8周或16周处死动物;液氮处理(冷冻)自体骨移植组,同样分别在重建后8周或16周处死动物。通过计算笼体末端、中心以及腹侧/背侧“反应”和“成熟骨”区域的比例,从组织学角度评估骨形成情况。反应区域含有带细胞核的骨细胞和成骨细胞,它们聚集在类骨质表面,而成熟骨区域可见层状结构。对于新鲜自体骨移植,重建后8周时反应和成熟骨区域显著增加至16周。相比之下,对于冷冻自体骨移植,重建后8周时反应骨区域未显著增加至16周,而成熟骨区域在此时间段内有所增加。两种移植类型在8周时笼体末端和背侧的反应骨比例均较高,仅新鲜自体骨移植在16周时笼体中心有更多的骨形成。因此,与新鲜自体骨移植相比,使用冷冻自体骨移植时脊柱前路重建部位的骨形成往往会延迟。然而,两组的骨形成过程相似,均从笼体与周围椎骨相邻的末端和背侧开始。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f3/5784937/50b5d6d050f3/pone.0191679.g001.jpg

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