Wang Yitian, Li Xiangfeng, Luo Yi, Zhang Li, Chen Hezhong, Min Li, Chang Qing, Zhou Yong, Tu Chongqi, Zhu Xiangdong, Zhang Xingdong
Department of Orthopedics, Orthopedics Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China.
Bone and Joint 3D-Printing & Biomechanical Laboratory, Department of Orthopedics, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu 610041, Sichuan, China.
Regen Biomater. 2022 Apr 11;9:rbac017. doi: 10.1093/rb/rbac017. eCollection 2022.
This study aimed at evaluating the possibility and effectiveness of osteoinductive bioceramics to fill the tumor cavity following the curettage of sacral giant cell tumor (GCT). Six patients (four females and two males, 25-45 years old) underwent nerve-sparing surgery, in which the tumor was treated by denosumab, preoperative arterial embolization and extensive curettage. The remaining cavity was filled with commercial osteoinductive calcium phosphate (CaP) bioceramics, whose excellent osteoinductivity was confirmed by intramuscular implantation in beagle canine. All patients were followed by computed tomography (CT) scans postoperatively. According to the modified Neer criterion, five cases obtained Type I healing status, and one case had Type II. At the latest follow-up, no graft-related complications and local recurrence were found. The CT scan indicated a median time of healing initiation of 3 months postoperatively, and the median time for relatively complete healing was 12 months. The excellent bone regenerative ability of the ceramics was also confirmed by increased CT attenuation value, blurred boundary and cortical rim rebuilding. In conclusion, osteoinductive CaP bioceramics could be an ideal biomaterial to treat the large remaining cavity following extensive curettage of sacral GCT. However, further investigation with more cases and longer follow-up was required to confirm the final clinical effect.
本研究旨在评估骨诱导生物陶瓷填充骶骨巨细胞瘤（GCT）刮除术后肿瘤腔的可能性及有效性。6例患者（4例女性，2例男性，年龄25 - 45岁）接受了保留神经手术，术中对肿瘤采用地诺单抗、术前动脉栓塞及广泛刮除治疗。剩余腔隙用市售骨诱导磷酸钙（CaP）生物陶瓷填充，其优异的骨诱导性已通过在比格犬肌肉内植入得到证实。所有患者术后均接受计算机断层扫描（CT）随访。根据改良的Neer标准，5例达到I型愈合状态，1例为II型。在最近一次随访时，未发现与移植物相关的并发症及局部复发。CT扫描显示术后愈合开始的中位时间为3个月，相对完全愈合的中位时间为12个月。CT衰减值增加、边界模糊及皮质边缘重建也证实了该陶瓷具有优异的骨再生能力。总之，骨诱导CaP生物陶瓷可能是治疗骶骨GCT广泛刮除术后大的剩余腔隙的理想生物材料。然而，需要更多病例及更长时间的随访进行进一步研究以确认最终临床效果。
