| Spinal fusion is a kind of operation method in which a stable mechanicalstructure is formed on both sides of thepathologic vertebrae by boneimplantation. This method can reduce the pain, delay the progress of deformity,lignten the stress and damage of spinal cord or nervus and reconstruct thestability of the patient’ spine. Albee used spinal fusion to treat tuberculosis ofspine so that the tuberculosis would not spread in1911. In the same year, Hibbsused spinal fusion to remedy scoliosis. Since Albee and Hibbs acquiredbreakthrough results, spinal fusion becomes one common operation method inthe spine surgery to treat the spine disease, which include spine fracture,spondylolisthesis, scoliosis, kyphos, tuberculosis of spine, ankylosingspondylitis, degenerative disc disease, etc. Bone graft material is inescapable inspinal fusion which include autogenous graft, allograft bone, xenogeneic boneand artificial bone. The golden standard of spinal fusion is autogenous graft, butthere are still many problems. Research of Sawin show that the complication ofautogenous graft in spinal fusion is about25.3%, which include haemorrhage,hemorrhage, fracture of the ilium, pain, injury of the nervus and soft tissue.Many researchers used allograft bone and xenogeneic bone in spinal fusion, but the osteogenic capability of allograft bone and xenogeneic bone is limited.Meanwhile they have the risk of infection, immunological rejection, spreadingdisease. In recent years, β-tricalcium phosphate include Biolu, MasterGraft,Olympus, as bone graft material have been used in spinal fusion surgery.Becauseβ-tricalcium phosphate only has bone conduction role, the effect offusion is limited, and the rate of fusion is low. A lot of research show that theosteogenesis effect of bone marrow stem cells combined with β-tricalciumphosphate is better than β-tricalcium phosphate alone. However, the tissueengineering bone of β-TCP/BMSCs has not been used in clinical, because ofsome reasons such as the number of bone marrow stem cells is not enough, theincubation time is long and the clinical needs can not be met.Objectives: The research use β-tricalcium phosphate scaffold whichcombined with bone marrow stem cells in spinal fusion of rabbit. In order tostudy the biocompatibility of the scaffold material, the osteogenesis effect of thetissue engineering bone(β-TCP/BMSCs), and the effect of different cellscarrying capacity on the tissue engineering bone.Methods:1) β-tricalcium phosphate combined with bone marrow stemcells after static culture for24hours. Activities of BMSCs were evaluated byMTT, scanning electron microscopy and fluorescence staining. Posterolateralspinal fusion was carried out in12White New Zealand rabbits using one of thefollowing graft materials in the bone solt:①β-tricalcium phosphate alone;②β-tricalcium phosphate combined with bone marrow stem cells. All the rabbitswere killed at12weeks after surgery and the bone repair effects were toevaluated by radiography, Mirco-CT, histologic analysis.2) The same number ofcells were combined with β-tricalcium phosphate at first. This tissueengineering bone which was respectively static cultured for1,3and7days was used for the posterolateral spinal fusion of New Zealand rabbit. The rate of newbone formation and lumbar fusion condition were observed by image, histologyobservation and histomorphometry.Results:1)24hours after inoculation, there were large number of BMSCson the surface and in the pore of the scaffold material by scanning electronmicroscopy and fluorescence staining. The cell which adhered to the surface andthe pole of the scaffold grow and expanded very well. New bone was observedin the tissue engineering bone group obviously by radiography, Mirco-CT,histologic analysis. However, almost no new bone can be found in theβ-tricalcium phosphate alone group.2) Cells on the material grew very well bythe observation of scanning electron microscope and fluorescent staining. Therate of cell activity on β-TCP/BMSCs after static culture1d,3d,7d was1:2.5:3.2. The date of X-ray, Micro-CT, histology observation and histomorphometryshow that the rate of new bone formation was1:1.89:1.98, and the rate oflumbar fusion was1:1.69:1.75.Conclusions:1) The β-TCP/BMSCs tissue engineering bone has a goodbiocompatibility.2) The β-TCP/BMSCs tissue engineering bone has bettercapacity to form new bone earlier compared with β-tricalcium phosphate alone.Therefore, this tissue engineering bone has a better application prospect.3) Theeffect of posterolateral spinal fusion is significantly affected by the cell contenton β-TCP/BMSCs, but which isn’t in proportion to the cell number. All thissuggests that the cell content has a critical value, the research of this criticalvalue will facilitate clinical practice and construction of cellular tissueengineering bone. |
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