Department of Spine Surgery, Hospital for Special Surgery, New York, NY.
Weill Cornell Medical College, New York, NY.
Spine (Phila Pa 1976). 2022 Nov 15;47(22):1607-1612. doi: 10.1097/BRS.0000000000004452. Epub 2022 Aug 9.
Prospective randomized placebo controlled animal trial.
Determine the effect of daily subcutaneous abaloparatide injection on the intervertebral fusion rate in rabbits undergoing posterolateral fusion.
Despite the wide utilization of spine fusion, pseudarthrosis remains prevalent, and results in increased morbidity. Abaloparatide is a novel analog of parathyroid hormone-related peptide (1-34) and has shown efficacy in a rat posterolateral spine fusion model to increase fusion rates. The effect of abaloparatide on the fusion rate in a larger animal model remains unknown.
A total of 24 skeletally mature New Zealand White male rabbits underwent bilateral posterolateral spine fusion. Following surgery, the rabbits were randomized to receive either saline as control or abaloparatide subcutaneous injection daily. Specimens underwent manual assessment of fusion, radiographic analysis with both x-ray and high-resolution peripheral quantitative computed tomography, and biomechanical assessment.
Rabbits that received abaloparatide had a 100% (10/10) fusion rate compared with 45% (5/11) for controls ( P <0.02) as assessed by manual palpation. Radiographic analysis determined an overall mean fusion score of 4.17±1.03 in the abaloparatide group versus 3.39±1.21 for controls ( P <0.001). The abaloparatide group also had a greater volume of bone formed with a bone volume of 1209±543 mm 3 compared with 551±152 mm 3 ( P <0.001) for controls. The abaloparatide group had significantly greater trabecular bone volume fraction and trabecular thickness and lower specific bone surface and connectivity density in the adjacent levels when compared with controls. Abaloparatide treatment did not impact trabecular number or separation. There were no differences in biomechanical testing in flexion, extension, or lateral bending ( P >0.05) between groups.
Abaloparatide significantly increased the fusion rate in a rabbit posterolateral fusion model as assessed by manual palpation. In addition, there were marked increases in the radiographic evaluation of fusion.
前瞻性随机安慰剂对照动物试验。
确定每日皮下给予阿巴洛肽对兔后路融合中椎间融合率的影响。
尽管脊柱融合广泛应用，但假关节仍然很常见，导致发病率增加。阿巴洛肽是甲状旁腺激素相关肽（1-34）的新型类似物，已在大鼠后路脊柱融合模型中显示出增加融合率的功效。阿巴洛肽在较大动物模型中对融合率的影响尚不清楚。
总共 24 只骨骼成熟的新西兰白兔接受双侧后路脊柱融合术。手术后，兔子被随机分为接受生理盐水作为对照或每日皮下注射阿巴洛肽。标本进行融合的手动评估、X 线和高分辨率外周定量计算机断层扫描的放射学分析以及生物力学评估。
接受阿巴洛肽治疗的兔子融合率为 100%（10/10），而对照组为 45%（5/11）（P<0.02），通过手动触诊评估。放射学分析确定阿巴洛肽组的总体平均融合评分为 4.17±1.03，而对照组为 3.39±1.21（P<0.001）。阿巴洛肽组形成的骨量也更大，骨体积为 1209±543mm 3，而对照组为 551±152mm 3（P<0.001）。与对照组相比，阿巴洛肽组相邻节段的小梁骨体积分数、小梁厚度更高，而特异性骨表面和连通密度更低。阿巴洛肽治疗对小梁数量或分离没有影响。两组在弯曲、伸展或侧屈的生物力学测试中没有差异（P>0.05）。
阿巴洛肽显著增加了兔后路融合模型中的融合率，通过手动触诊评估。此外，融合的放射学评估也有明显增加。
