| Objective:To explore the therapeutic effect and mechanism of Osteoking on bone reconstruction by observing the experimental research and preliminary clinical application.Methods:(1) 22 healthy male New Zealand rabbits were selected and randomly divided into 3 groups, group A (treatment group, n=9); group B (model group, n=9) and group C (normal group, n=4). Group A and B were performed with lumbar laminectomy and bone grains replantation surgery. Osteoking was offered to group A and normal saline(NS) at the same dose was offered to group B after modeling. No surgery procedure was offered to group C but same dose of NS. Observation of adhered tissue and morphological changes, determination of hydroxyproline(Hyp) as well as CT scan were performed after 4,8 and 12 weeks’treatment. (2) Preliminary Clinical Application:A prospective study was conducted. 50 patients that required surgery treatment due to lumbar disc herniation was collected from Oct 2013 to Aug 2014 and randomly assigned into treatment group and control group. Finally 41 patients were collected into the data for statistics analysis due to the follow up issue (41/50), including 21 cases in treatment group that treated with regular therapy and Osteoking and 20 cases in control group that treated with regular therapy, with a follow up 6 months. Visual analogue score (VAS) and Oswestry back disability index (ODI) were adopted to assess the improvement on clinical symptoms one day before the operation,1,3 and 6 months after the operation. CT scan were also performed postoperatively to observe the reconstruction. SPSS 18.0 software was utilized for statistics analysis.Result:(1)Experimental part:Though the gross observation and histological observation, the results of group A which Rydell and organization classification were far lower than group B (P<0.05). Expression of Hyp showed that the A group had the lower epidural adhesion compared with the B group (P<0.05). After 12 weeks of surgery, CT examination showed the bone plate which formed by bone grain in A group was connected with the vertebral bone, which canal morphology and volume had no obvious change, and no spinal cord compression; group B show segment lamina defect which a small scar protruding into the spinal canal, and the vertebral canal reconstruction is not complete. (2)Clinical part:41 cases of 50 cases received follow-up (follow-up rate was 82.0%). Two groups were compared baseline characteristics (age, course of disease, outstanding section, outstanding section, type of lumbar discherniation, preoperative VAS, ODI score and CT value of 3 days after surgery), there was no significant difference (P>0.05). Two groups of patients received 6 months of follow-up, no spinal stenosis, nerve, blood vessel injury. The VAS scores of treatment group at 1,3, and 6 months after surgery were lower than those of the control group, the difference was statistically significant (P<0.05). There was significant differences in ODI score between the two groups at postoperative 1,6 months (p<0.05), the effect of the treatment group is better than the control group. CT examination showed that the treatment group broken granular bone graft CT value at postoperative 3,6 months increased significantly compared with the control group, the difference has statistical significance, (P<0.05).Conclution:(1)Osteoking can effectively promote bone reconstruction in the lamina of rabbits, and the bone plate can prevent scar from expanding into the spinal canal, and can reduce the intraspinal conglutination. (2)The clinical effect of Osteoking combined with bone grafts replantation is satisfaction, and the autologous bone grain reconstruction effect is good. Thus it can effectively reduce epidural adhesion with fewer complications, can be researched further in clinical. |
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