Chen Lin, Xiu Zhigang, Hu Xu, Yang Yi, Liu Hao
Department of Orthopedics Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China.
Department of Orthopedics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan Province, China.
BMC Musculoskelet Disord. 2025 Apr 5;26(1):335. doi: 10.1186/s12891-025-08567-2.
To quantitatively investigate the effects of Modic-III changes on the porous bone ingrowth at the interface of cervical disc prosthesis using caprine models.
The Modic-III changes were induced at C3-4 level in eight goats by discectomy, followed by the implantation of cervical disc prostheses, while another eight goats served as a control group. Computed tomography (CT) and X-rays of cervical spine were performed intraoperatively and postoperatively at verify implant placement. The vertebral specimens were examined by micro-CT for histomorphometric quantification, including bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th). Methylene-blue/acid fuchsin staining, standard hematoxylin and eosin staining, and Masson staining were used for histologic evaluation. Immunohistochemical staining, including osteocalcin (OCN), alkaline phosphate (ALP), and runt-related transcription factor 2 (RUNX2), were also conducted.
All goats were followed for a period of 6 months after prosthesis implantation. The rate of prosthesis complications in experimental group was significantly higher than that in control group (37.5% vs. 12.5%, P = 0.046). The histomorphometric parameters of experimental group, including BV/TV, Tb.N, Tb.Th, and bone ingrowth percentage were significantly lower than those of control group. The histologic sections of control group showed the excellent bone ingrowth and close contact between bone and prosthesis interface. By contrast, in experimental group, plenty of interfacial gaps were filled up with abundant fibrous tissue. The immunohistochemical sections of control group demonstrated the bone trabecula was surrounded by numerous osteoblasts, compared with the clear and smooth bone trabecula margin surrounded by few osteoblasts in experimental group. Moreover, the experimental group had significantly lower integrated optical density values of OCN, ALP, and RUNX2 staining.
The Modic-III changes significantly impaired the osseointegration of artificial cervical disc in caprine models by reducing the number of osteoblasts, BV/TV, Tb.N, Tb.Th, bone ingrowth percentage and down-regulating the expression levels of ALP, Osteocalcin, and Runx-2, possibly leading to more occurrence of prosthesis complications.
采用山羊模型定量研究Modic-III型改变对颈椎间盘假体界面处骨长入的影响。
8只山羊在C3-4水平行椎间盘切除术后诱导产生Modic-III型改变，随后植入颈椎间盘假体，另8只山羊作为对照组。术中及术后行颈椎计算机断层扫描（CT）和X线检查以确认植入物位置。对椎体标本进行显微CT检查以进行组织形态计量学定量分析，包括骨体积分数（BV/TV）、骨小梁数量（Tb.N）、骨小梁厚度（Tb.Th）。采用亚甲蓝/酸性品红染色、标准苏木精和伊红染色以及Masson染色进行组织学评估。还进行了免疫组织化学染色，包括骨钙素（OCN）、碱性磷酸酶（ALP）和 runt相关转录因子2（RUNX2）。
所有山羊在假体植入后随访6个月。实验组假体并发症发生率显著高于对照组（37.5%对12.5%，P = 0.046）。实验组的组织形态计量学参数，包括BV/TV、Tb.N、Tb.Th和骨长入百分比均显著低于对照组。对照组组织学切片显示骨长入良好，骨与假体界面紧密接触。相比之下，实验组有大量界面间隙被丰富的纤维组织填充。对照组免疫组织化学切片显示骨小梁被大量成骨细胞包围，而实验组骨小梁边缘清晰光滑，周围成骨细胞较少。此外，实验组OCN、ALP和RUNX2染色的积分光密度值显著较低。
Modic-III型改变通过减少成骨细胞数量、BV/TV、Tb.N、Tb.Th、骨长入百分比并下调ALP、骨钙素和Runx-2的表达水平，显著损害了山羊模型中人工颈椎间盘的骨整合，可能导致更多的假体并发症发生。
