Qian Guang, Wang Minghai, Dong Youhai, Hong Yang, Yu Yueming, Mei Jiong
Tongji University School of Medicine, Tongji University, Shanghai, China; Department of Orthopedics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Department of Orthopedics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Ann Palliat Med. 2021 Feb;10(2):1070-1078. doi: 10.21037/apm-20-473. Epub 2020 Sep 22.
Both pulsed electromagnetic field (PEMF) stimulation and sclerostin monoclonal antibody are useful for treating osteoporosis, but whether the two therapies have synergistic effects on both screw fixation quality and bone metabolism of ovariectomy-induced osteoporosis has not been reported.
We used ovariectomy to create a rabbit model of postmenopausal osteoporosis. Then, specimens were fixed with pedicle screws in the L4 vertebral body. Rabbits were randomly divided into an OVX control group, PEMF group, Scl-Ab group, and PEMF+Scl-Ab group. The PEMF group was given PEMF magnetic therapy, the Scl-Ab group was administered a subcutaneous Scl-Ab injection, and the PEMF+SclAb group received both therapies. The OVX group was injected subcutaneously with the same dose of saline instead. After eight weeks of treatment, the bone metabolism index, bone mineral density (BMD), and bone microstructural, biological, and biomechanical parameters were evaluated.
BMD significantly decreased six months post-ovariectomy. Compared with that of the OVX group, the BMD of the PEMF, Scl-Ab, and PEMF+Scl-Ab groups increased by 20.3%, 19.9%, and 35.0%, respectively. The maximum pulling force of pedicle screws increased by 14.0%,15.0% and 19.1%, and the maximum failure power consumption of pedicle screws increased by 27.9%, 27.2% and 33.6%, respectively; these differences were statistically significant (P<0.05). The bone metabolism index and bone microstructure parameters of the PEMF+Scl-Ab group were more optimal than those in the single treatment group.
Both Scl-Ab and PEMF therapy can enhance the BMD and the mechanical strength of pedicle screws in osteoporotic bones of rabbits with postmenopausal osteoporosis. However, combination of the two measures has achieved even better results, yielding potential clinical application value.
脉冲电磁场（PEMF）刺激和硬化蛋白单克隆抗体均对骨质疏松症治疗有效，但两种疗法对卵巢切除所致骨质疏松症的螺钉固定质量和骨代谢是否具有协同作用尚无报道。
我们采用卵巢切除术建立绝经后骨质疏松症兔模型。然后，在L4椎体用椎弓根螺钉固定标本。将兔子随机分为卵巢切除对照组、PEMF组、Scl-Ab组和PEMF+Scl-Ab组。PEMF组给予PEMF磁疗，Scl-Ab组皮下注射Scl-Ab，PEMF+SclAb组接受两种治疗。卵巢切除组皮下注射相同剂量的生理盐水。治疗8周后，评估骨代谢指标、骨密度（BMD）以及骨微观结构、生物学和生物力学参数。
卵巢切除术后6个月骨密度显著降低。与卵巢切除组相比，PEMF组、Scl-Ab组和PEMF+Scl-Ab组的骨密度分别增加了20.3%、19.9%和35.0%。椎弓根螺钉的最大拉力分别增加了14.0%、15.0%和19.1%，椎弓根螺钉的最大失效功耗分别增加了27.9%、27.2%和33.6%；这些差异具有统计学意义（P<0.05）。PEMF+Scl-Ab组的骨代谢指标和骨微观结构参数比单一治疗组更优。
Scl-Ab和PEMF疗法均可提高绝经后骨质疏松症兔骨质疏松骨的骨密度和椎弓根螺钉的机械强度。然而，两种措施联合使用取得了更好的效果，具有潜在的临床应用价值。
