神经植入对大段组织工程骨成骨效果的一年观察

目的 观察在组织工程骨内植入神经束后大段组织工程骨的长期成骨效果.方法 新西兰大白兔64只,随机分为四组:A组,单纯组织工程骨组;B组,运动神经束植入组(股神经肌支);C组,感觉神经束植入组(隐神经);D组,感觉、运动神经束联合植入组.每只动物均在左侧股骨制作长1.5 cm的段缺性骨与骨膜缺损,钢板固定后在骨缺损处分别植入四种方法制备的组织工程骨.术后1、3、6、12个月行大体观察、X线和组织学定量观察成骨情况. 结果 术后1、3、6个月时,在组织工程骨内植入感觉神经或联合植入两种神经后,比单纯组织工程骨和运动神经束植入的修复效果均有明显提高.术后12个月时,各组骨再生情况基本一致,但新生骨组织出现一定程度的吸收,其外观较正常股骨细,新生骨组织与兔股骨牢固愈合,并开始塑形且出现髓腔再通. 结论 在组织工程骨内植入感觉神经可促进成骨,而植入运动神经未见促进作用;组织工程骨可以修复兔大段骨缺损;该实验新生骨组织的吸收可能与模型的制作方法有关.

Effects of nerve implantation on osteogenesis of large tissue-engineered bone: one-year observation

Objective To investigate the long-term effects of nerve-tract Implantation on in vivo osteogenesis of large tissue-engineered bone. Methods A segmental bone defect of 1.5 cm long was made at the left femur in each of the 64 New Zealand rabbits which were divided into 4 equal groups randomly.After plate fixation, the defects of each group were implanted with the engineered-bone prepared in each of the following 4 ways respectively: non-nerve implantation (group A), motor nerve-tract implantation (group B,muscular branches of femoral nerves), sensory nerve-tract implantation (group C, saphenous nerves), and sensory plus motor nerve-tract implantation (group D) . At 1, 3, 6 and 12 months postoperatively, gross observation, X-ray examination and histological examination were performed to evaluate the engineered-bone and the new bone formation. Results At 1, 3 and 6 months post-operatively, implantation of sensory nerve into the tissue-engineered bone (groups C and D) bad obviously better reparative effect than the methods of groups A and B. At 12 months post-operatively, there was no significant difference in osteanagenesis among the 4 groups, and gradual absorption of the new forming bone occurred. The new bone formation appeared thinner than the normal femur but bound firmly with the femur. Moulding and medullary cavity reeanalization were observed in the new bone formation. Conclusions Implantation of sensory nerve-tract into tis-sue-engineered bone can improve osteogenesis, but implantation of motor nerve-tract seems to have no such effect. Tissue-engineered bone may repair large bone defects in rabbits.