阿伐他汀激活wnt/β-catenin信号通路促进骨质疏松模型大鼠移植物的骨整合

BACKGROUND: Atorvastatin has been shown to reduce bone loss and fracture, but its effects on implant osseointegration remain unknown. OBJECTIVE: To investigate the effects of atorvastatin on implant osseointegration in osteoporotic rats and the underlying mechanisms. METHODS: Forty-eight Sprague-Dawley rats were randomized into sham-surgery, ovariectomy, and atorvastatin (10 and 20 mg/kg per day) treatment groups, respectively. All rats received ovariectomy and implant surgery except those in the sham-surgery group. Bone mineral density of the lumbar vertebra, osseointegration ratio and pull-out strength of implants were measured after 12-week treatment. Levels of bone formation and resorption markers in osteoblasts treated with atorvastatin were determined by ELISA. Wnt pathway-related gene expression was detected by RT-PCR. RESULTS AND CONCLUSION: Bone mineral density, osseointegration ratio and pull-out strength of implants were significantly increased in 20 mg/kg per day of atorvastatin treatment group compared with ovariectomy group (P < 0.05). Levels of alkaline phosphatase, osteocalcin and osteoprotegerin were significantly increased in osteoblasts treated with atorvastatin in vitro (P < 0 .05), and the level of osteoclast differentiation factor RANKL was significantly inhibited (P < 0.05). Meanwhile, atorvastatin significantly promoted the mRNA expression of low-density lipoprotein associated protein 5 and β-catenin, and inhibited the mRNA expression of dickkopf Wnt signal pathway inhibitor 1 and sclerostin. Our results suggest that atorvastatin promotes implant osseointegration in osteoporotic rats by activating Wnt/β-catenin signal pathway. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

单侧双通道内镜技术治疗神经根型颈椎病的早期临床疗效

颈前路减压植骨融合术（anterior cervical decompression and fusion,ACDF）是治疗神经根型颈椎病的常用术式。但椎间融合使脊柱节段生物力学发生改变,加速临近节段退变。传统的颈后路开窗减压髓核摘除术不需要融合手术节段,但需要广泛剥离软组织,出血较多、易导致颈椎不稳及轴性疼痛等并发症。随着微创技术的发展,应用脊柱内镜技术治疗神经根型颈椎病为骨科医生提供了更多选择。单侧双通道内镜技术（unilateral biportal endoscopy,UBE）使用观察和操作2个通道,观察通道放置内镜的同时具备冲洗功能,操作通道则用于手术器械操作。相对于传统颈椎后路手术,该技术具有创伤小、出血少、恢复快等优势。但目前应用UBE技术治疗神经根型颈椎病的报道相对较少。2021年3月～2021年11月,我们应用UBE技术治疗9例神经根型颈椎病患者,取得了较好的临床疗效,报道如下。