| A solid bone fusion is necessary after correction of spine deformities for children. The transplantation bone fusion materials include selfbone; homologous bone and other artificial biomaterials. Recently the homolous bone allograft become more and more important because of the rarely of selfbone and the expensive and unstable of biomaterials. The observations about growth abilities of be absorbed rate in the homologous bone, and the study about decreased immune respose and increased the growth abilities of homologous bone have been paid greatly attentions. The more and more valued studies about increase growth abilities and decrease immune response after homologous bone allograft have been reported by many scholar. Meanwhill the built of bone bank that have perfect quality system has made it possible to the widely applied and the developmentof homologous bone allograft technique. We divided the 123 cases spine fusion children in our hospital after operation into three groups, according to the different of fusion materials, analyse the results of clinical observations and immune examinations and get the conclusions is .'although there were ealier immune responses after large amounts homologous bone allograft, if we put selfbone with homologous bone mixided to perform spine fusion, the immune responses will be decreased and we can get solid fusion results. Meanwhile, we have finished animal experiment, used histology; immunohistochemistry; tetracycline immunofloarescenc observations, we studiedhistological changes after homologous bone allograft, observed how that Haverian system joint in the ostegenesis and the rebuilt of homologous bone, and observed the activities of BMP in the homologous bone. Through analysed the results of animal experiments, we have got the conclusions:firstly,the healing process of the homologous bone allograft is the result of absorb with crawl and supersede;secondly,the ostegenesis around homologous bone was got by invasion of soft tissue and the formation of bone absorb lacuna; thirdly, there were some BMP activities in the homologous bone after homologous allografts; forthly, ostegenesis showed in Haversian system at 4 weeks after homologous allograft. Because of the influences of time and materials, we can not finished the observations that the influence of light degress immune response to the ostegenisis;the rules of ostegenesis in Haverian sestem of homologous bonesand the mechanisms of BMPinthe homologous bones. We wished that will be finished in the future.Part I Oberservation of clinical and immune changes after children's spine fusion using homelogous bone allograftAbstract: Objective To study clinical responses and immune changes after children' s spine fusion using homologous bone allograft. Methods From 1999 to 2004 123 spine correction cases were got following up. According to the differents of fusion materials, we divided them into three groups:first group was 48 cases,the fusion material was self-bone. Second group was 64 cases , the fusion material was mixiture of self-bone and honelogous bone (self-bone>60%). Third group was 21 cases.The fusion material was mixture self-bone and homologous bone (homologous bone >60%). Observeded and recorded the results of clinical signs;laboratory examinations;immune cheching;radiology and istopic examinations, analysed and compared the observated results. Results We did not find obvious immune reactions in the first and second groups,but there were three cases in the third group were found earlier immune responses. Included : after operation temperatures kept in higher;aseptic exudates in wounds;CRP kept higher;large amount lymphocytes were found in pathologic sections;no new bone performed and no reactions of periosteam. We examinated obviously increased of CD4+and CD4+/CD8+through immune examination. By long time following up, we did not find out obviously different about the callus perform bettewen three groups. Conclusion Although there ealier immune responses after large amount homologous bone allograft, but if...
|
PDF Full Text Request