文献类型：期刊文献

中文题名：复合rhBMP-2的注射型磷酸钙人工骨在椎体成形术中的应用及生物力学评价

英文题名：An in vitro biomechanical evaluation of injectable calcium phosphate cement/recombined human bone morphogenetic protein-2 composite used in vertebroplasty

作者：刘宏建[1];陈勇[2];杜靖远[1];梁惠民[3];刘昌胜[4];汪岚[5]

机构：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022;[2]华中科技大学同济医学院附属同济医院康复医学科;[3]华中科技大学同济医学院附属协和医院介入放射科,武汉430022;[4]华东理工大学上海瑞邦生物材料有限公司;[5]华中科技大学同济医学院附属协和医院生物力学实验室,武汉430022

年份：2004

卷号：26

期号：7

起止页码：392

中文期刊名：中华物理医学与康复杂志

外文期刊名：Chinese Journal of Physical Medicine and Rehabilitation

收录：CSTPCD;;北大核心:【北大核心2000】；CSCD:【CSCD2011_2012】；

语种：中文

中文关键词：复合rhBMP-2;注射型磷酸钙;人工骨;椎体成形术;生物力学;充填材料

外文关键词：Osteoporosis; Biomechanics; Vertebroplasty; PMMA; CPC; rhBMP-2; rhBMP-2/CPC

摘要：目的　通过将复合有重组人类骨形态发生蛋白 2 (rhBMP 2 )的注射型磷酸钙人工骨 (rhBMP 2 /CPC)应用于体外经皮椎体成形术 (PVP)实验中 ,观察并评价其生物力学性能 ,以探寻rhBMP 2 /CPC能否有效替代聚甲基丙烯酸甲酯 (PMMA)而应用于PVP手术。方法　选取 6具尸体脊柱标本 (T8～L5)并测试骨密度 ,然后将其游离成 60个椎体并随机分为 4组 :I组为空白对照组 (n =3 0 ) ;II组为PMMA组 (n =10 ) ;III组为CPC组 (n =10 ) ;IV组为rhBMP 2 /CPC组 (n =10 )。在“C”形臂X线机导引下 ,II～IV组椎体经双侧椎弓根分别充填PMMA、CPC及rhBMP 2 /CPC ;在万能材料实验机上将所有椎体压缩至原始高度的 5 0 % ,测得最大载荷及刚度 ;随后将I组再进一步划分为IA、IB及IC组 ,分别充填PMMA、CPC及rhBMP 2 /CPC ,按前述加载方法再次压缩至充填后椎体高度的 5 0 %。结果　实验开始前 ,各组椎体BMD为 ( 0 .3 10～ 0 .689)g/cm2 ,高度为 ( 1.64～ 3 .0 9)cm (组间比较 ,均P >0 .0 5 )。IA、IB及IC组充填后椎体前缘高度分别增加 ( 0 .16±0 .0 5 )cm ,( 0 .18± 0 .0 7)cm和 ( 0 .2 1± 0 .0 9)cm ,与充填前比较 ,差异无显著性意义 (均P >0 .0 5 )。材料充填量方面 :IA组是 ( 2 .8± 0 .7)ml,IB组是 ( 2 .3± 0 .3 )ml,IC组是 (
Objective To evaluate the biomechanical performance of the injectable calcium phosphate cement (CPC) recombined human bone morphogenetic protein-2(rhBMP-2/CPC) in an in vitro vertebroplasty model. Methods A total of 60 vertebral bodies(VBs) obtained from 6 cadaveric thoracolumbar spine (T 8～L 5) were used.After the bone mineral density (BMD) of each VB was measured using a dual energy X-ray absorptiometry (DEXA),the VBs were assigned into 4 groups,intact control group (group I),polymethylmethacrylate (PMMA) injection group(group II),CPC injection group (group III) and rhBMP-2/CPC injection group(group IV). The VBs were then fixed on a material testing system and compressed to 50% of their original heights,respectively. After fracture,the VBs in group I were further divided into 3 subgroups and injected with PMMA(group IA),CPC(group IB) or rhBMP-2/CPC(group IC),respectively. The VB height was measured again after cement injection to evaluate the magnitude of the regained height,and these VBs were compressed to 50% of the post-injection height. Force and displacement data were recorded and used to determine the maximum load and stiffness. Results BMDs of all tested groups ranged from 0.310 to 0.689 g/cm 2( P >0.05),VBs height ranged from 1.64 to 3.09 cm( P >0.05). For groups II,III,IV,IA,IB and IC,3.2±2.6ml,3.1±1.9ml,2.9±1.4ml,2.8±0.7ml,2.3±0.3ml and 2.4±0.3 ml of cement were injected on average( P >0.05),respectively. No significant difference was revealed in the mean VB height regained by injection of PMMA. The maximum load of groups II,III,IV and IA were greater than that of group I ( P <0.05) ,no significant difference was found among groups IC,IB and I. Stiffness of groups II,III,IV and IA were greater than that of group I( P <0.05),and the stiffness of group I was greater than that of group IC( P <0.05),while no significant difference was found between groups I and IB( P >0.05). Conclusion CPC and rhBMP-2/CPC can improve the biomechanical strength of the VB,and could be used as the substitute of the PMMA in the percutaneous vertebroplasty operation.