Xia Yu-Dong, Zhang Rong, Liu Qiong, Chen Jia-Ru
Department of Spinal Trauma Surgery, Changshou District People's Hospital, Chongqing 401220, China.
Department of Emergency, Changshou District People's Hospital, Chongqing 401220, China.
Zhongguo Gu Shang. 2024 Jan 25;37(1):15-20. doi: 10.12200/j.issn.1003-0034.20221048.
To investigate the effect of bone cement containing recombinant human basic fibroblast growth factor (rhbFGF) and recombinant human bone morphogenetic protein-2 (rhBMP-2) in percutaneous kyphoplasty(PKP)treatment of osteoporotic vertebral compression fracture(OVCF).
A total of 103 OVCF patients who underwent PKP from January 2018 to January 2021 were retrospectively analyzed, including 40 males and 63 females, aged from 61 to 78 years old with an average of (65.72±3.29) years old. The injury mechanism included slipping 33 patients, falling 42 patients, and lifting injury 28 patients. The patients were divided into three groups according to the filling of bone cement. Calcium phosphate consisted of 34 patients, aged(65.1±3.3) years old, 14 males and 20 females, who were filled with calcium phosphate bone cement. rhBMP-2 consisted of 34 patients, aged (64.8±3.2) years old, 12 males and 22 females, who were filled with bone cement containing rhBMP-2. And rhbFGF+rhBMP-2 consisted of 35 patients, aged (65.1±3.6) years old, 14 males and 21 females, who were filled with bone cement containing rhbFGF and rhBMP-2. Oswestry disability index (ODI), bone mineral density, anterior edge loss height, anterior edge compression rate of injured vertebra, visual analog scale (VAS) of pain, and the incidence of refracture were compared between groups.
All patients were followed for 12 months. Postoperative ODI and VAS score of the three groups decreased (<0.001), while bone mineral density increased (<0.001), anterior edge loss height, anterior edge compression rate of injured vertebra decreased first and then slowly increased (<0.001). ODI and VAS of group calcium phosphate after 1 months, 6 months, 12 months were lower than that of rhBMP-2 and group rhbFGF+rhBMP-2(<0.05), bone mineral density after 6 months, 12 months was higher than that of rhBMP-2 and group calcium phosphate(<0.05), and anterior edge loss height, anterior edge compression rate of injured vertebra of group rhbFGF+rhBMP-2 after 6 months and 12 months were lower than that of group rhBMP-2 and group calcium phosphate(<0.05). There was no statistical difference in the incidence of re-fracture among the three groups (>0.05).
Bone cement containing rhbFGF and rhBMP-2 could more effectively increase bone mineral density in patients with OVCF, obtain satisfactory clinical and radiological effects after operation, and significantly improve clinical symptoms.
探讨含重组人碱性成纤维细胞生长因子（rhbFGF）和重组人骨形态发生蛋白-2（rhBMP-2）的骨水泥在经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折（OVCF）中的作用。
回顾性分析2018年1月至2021年1月行PKP的103例OVCF患者，其中男性40例，女性63例，年龄61～78岁，平均（65.72±3.29）岁。损伤机制包括滑倒33例、坠落42例、提拉伤28例。根据骨水泥填充情况将患者分为三组。磷酸钙组34例，年龄（65.1±3.3）岁,男性14例，女性20例，填充磷酸钙骨水泥；rhBMP-2组34例，年龄（64.8±3.2）岁，男性12例，女性22例，填充含rhBMP-2的骨水泥；rhbFGF+rhBMP-2组35例，年龄（65.1±3.6）岁，男性14例，女性21例，填充含rhbFGF和rhBMP-2的骨水泥。比较各组患者的Oswestry功能障碍指数（ODI）、骨密度、伤椎前缘丢失高度、伤椎前缘压缩率、疼痛视觉模拟评分（VAS）及再骨折发生率。
所有患者均随访12个月。三组患者术后ODI和VAS评分均降低（<0.001），骨密度升高（<0.001），伤椎前缘丢失高度、伤椎前缘压缩率先降低后缓慢升高（<0.001）。磷酸钙组术后1个月、6个月、12个月的ODI和VAS低于rhBMP-2组和rhbFGF+rhBMP-2组（<0.05），术后6个月、12个月的骨密度高于rhBMP-2组和磷酸钙组（<0.05），rhbFGF+rhBMP-2组术后6个月和12个月的伤椎前缘丢失高度、伤椎前缘压缩率低于rhBMP-2组和磷酸钙组（<0.05）。三组再骨折发生率比较，差异无统计学意义（>0.05）。
含rhbFGF和rhBMP-2的骨水泥能更有效地提高OVCF患者的骨密度，术后获得满意的临床及影像学效果，显著改善临床症状。
