Silcox D H, Boden S D, Schimandle J H, Johnson P, Whitesides T E, Hutton W C
Emory Spine Center, Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA.
Spine (Phila Pa 1976). 1998 Feb 1;23(3):291-6; discussion 297. doi: 10.1097/00007632-199802010-00001.
The effect on spinal fusion of an osteoinductive bone protein extract in the presence of a known inhibitor of spinal fusion (systemic nicotine) was studied prospectively in an animal model of posterolateral lumbar fusion.
To evaluate the ability of a bovine-derived osteoinductive bone protein extract to overcome the inhibitory effect of nicotine in a rabbit spine fusion model.
Multiple studies have demonstrated the ability of a variety of osteoinductive growth factors to serve as a bone graft substitute for lumbar spinal fusion under "normal" healing conditions.
Forty-eight adult female New Zealand white rabbits underwent spine arthrodesis at L5-L6 while receiving systemic nicotine through a subcutaneous miniosmotic pump. Arthrodesis was performed using one of the following three graft materials: 1) autogenous iliac crest, 2) osteoinductive bone protein delivered in an allogeneic demineralized bone matrix/ collagen carrier, or 3) osteoinductive bone protein delivered with autogenous iliac crest. Fusions were assessed by blinded manual palpation, radiography, and biomechanical testing.
Of the 44 rabbits manually tested by blinded observers, all 14 in the osteoinductive bone protein plus autogenous iliac crest bone group had solid fusions (14 of 14), whereas the fusion rate was less in the osteoinductive bone protein plus demineralized bone matrix group (nine of 14, 64%; P = 0.02), and there were no fusions in the autogenous iliac crest only group (0 of 16, 0%; P = 0.000001). The use of osteoinductive bone protein with autogenous bone produced stronger and stiffer fusions compared with those using autogenous bone alone or osteoinductive bone protein with allograft bone.
Cigarette smoking and nicotine are inhibitory factors in the healing of fractures and spine fusions. This study shows that the inhibitory effect of nicotine can be overcome with an osteoinductive bone growth factor in an animal model.
在腰椎后外侧融合的动物模型中，前瞻性地研究了一种骨诱导性骨蛋白提取物在存在已知的脊柱融合抑制剂（全身性尼古丁）的情况下对脊柱融合的影响。
在兔脊柱融合模型中评估牛源性骨诱导性骨蛋白提取物克服尼古丁抑制作用的能力。
多项研究表明，多种骨诱导性生长因子在“正常”愈合条件下有能力作为腰椎脊柱融合的骨移植替代物。
48只成年雌性新西兰白兔在L5-L6节段进行脊柱融合术，同时通过皮下微型渗透泵接受全身性尼古丁。使用以下三种移植材料之一进行融合术：1）自体髂嵴；2）在同种异体脱矿骨基质/胶原载体中递送的骨诱导性骨蛋白；3）与自体髂嵴一起递送的骨诱导性骨蛋白。通过盲法手动触诊、放射照相和生物力学测试评估融合情况。
在由盲法观察者进行手动测试的44只兔子中，骨诱导性骨蛋白加自体髂嵴骨组的14只兔子全部实现了牢固融合（14/14），而骨诱导性骨蛋白加脱矿骨基质组的融合率较低（14只中有9只，64%；P = 0.02），仅自体髂嵴组未出现融合（16只中有0只，0%；P = 0.000001）。与单独使用自体骨或骨诱导性骨蛋白与同种异体骨相比，使用骨诱导性骨蛋白与自体骨可产生更强且更硬的融合。
吸烟和尼古丁是骨折愈合和脊柱融合的抑制因素。本研究表明，在动物模型中，骨诱导性骨生长因子可克服尼古丁的抑制作用。
