Rahyussalim Ahmad Jabir, Ivansyah Muhammad Deryl, Nugroho Ahmad, Wikanjaya Rio, Canintika Anissa Feby, Kurniawati Tri
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Divion of Spine, Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Int J Surg Case Rep. 2020;66:304-308. doi: 10.1016/j.ijscr.2019.12.002. Epub 2019 Dec 12.
Vertebral body defects (VBDs) are one of the most frequent orthopaedic disorders. Such defects often require bone grafts or fusion procedures; however, both procedures often fail due to various factors. Mesenchymal stem cells (MSCs) have been used as a potential therapy to fill bone voids in bone defects, and they may be a potential treatment for VBDs. We reported VBDs treated with MSCs combined with hydroxyapatite scaffolds.
A 27-year-old female presented with recurrent back pain. She had a history of decompression and stabilization procedure one year ago after diagnosed with spinal tuberculosis. Initially, she felt back pain that intensifies with activity and relieved with rest. She noticed that the pain begun when once she heard a crack sound on her back while trying to get up from sitting position. There was no history of numbness or tingling sensation. There were no walking problems. Other functions, including micturition and defecation, were within normal limits. The patient firstly underwent lumbotomy procedure, and the images were all confirmed with fluoroscopy X-ray. The vertebrae went debridement, and finally, the bone defect was filled with 20 millions of umbilical cord-mesenchymal stem cells (UC-MSCs) combined with hydroxyapatite in 2 cc of saline.
At three months postoperative, the patient could walk and had no pain. At six months of follow-up, no complications occurred. We also did not see any signs of neoplasm formation, which is consistent with previous studies that used MSCs for orthopaedic treatment. Moreover, no significant bone deformation or spinal cord compression was observed, which suggested the safety of the transplantation procedure.
We found that MSCs combined with hydroxyapatite represents a potential therapy for bone regeneration in VBD. Further clinical studies are required to investigate the safety and efficacy of this combination of therapy in VBDs.
椎体缺损（VBDs）是最常见的骨科疾病之一。此类缺损通常需要进行骨移植或融合手术；然而，由于各种因素，这两种手术常常失败。间充质干细胞（MSCs）已被用作填充骨缺损中骨空隙的一种潜在治疗方法，它们可能是治疗VBDs的一种潜在手段。我们报道了用MSCs联合羟基磷灰石支架治疗VBDs的情况。
一名27岁女性因反复背痛前来就诊。她一年前被诊断为脊柱结核，曾接受减压和稳定手术。最初，她感到背痛，活动时加重，休息时缓解。她注意到疼痛始于一次她试图从坐姿起身时背部听到一声爆裂声。无麻木或刺痛感病史。无行走问题。包括排尿和排便在内的其他功能均在正常范围内。患者首先接受了腰椎切开手术，所有图像均经荧光透视X线确认。对椎体进行了清创，最后，在2毫升盐水中将2000万个脐带间充质干细胞（UC-MSCs）与羟基磷灰石混合用于填充骨缺损。
术后三个月，患者能够行走且无疼痛。随访六个月时，未发生并发症。我们也未发现任何肿瘤形成的迹象，这与先前使用MSCs进行骨科治疗的研究一致。此外，未观察到明显的骨变形或脊髓压迫，这表明移植手术的安全性。
我们发现MSCs联合羟基磷灰石是治疗VBDs骨再生的一种潜在疗法。需要进一步的临床研究来调查这种联合疗法在VBDs中的安全性和有效性。
