辛伐他汀对颈椎异体骨移植融合过程的影响

目的 研究辛伐他汀对颈椎异体骨皮质移植融合过程的影响. 方法 健康成年雄性Wistar大鼠44只,随机分为对照组、辛伐他汀组、重组人骨形态发生蛋白-2(rhBMP-2)组及空白对照组,前3组行颈椎前路间盘切除异体骨皮质椎间移植融合术.分别在手术后2、4、8和12周将动物处死,取出颈椎后拍摄X线片,观察融合情况,双能量骨密度仪测量颈椎椎体骨密度;颈椎标本组织化学染色观察椎体骨小梁同植骨块表面融合,及植骨内部的血管新生和骨形成的情况. 结果 颈椎骨密度对照组较空白对照组明显降低(P<0.01),而辛伐他汀组和rhBMP-2组颈椎椎体骨密度同空白对照组无明显差别.病理显示,对照组炎性纤维组织长期存在,术后3月植骨界面有少量的软骨内成骨;而辛伐他汀组术后炎性纤维组织形成少,存在时间短;在术后第8周辛伐他汀组及rh BMP-2组异体骨表面均可与椎体骨小梁发生骨性融合;植骨12周,rhBMP-2组植骨内部的血管侵入和骨质形成较少,而辛伐他汀组植骨内部可见较多的新生血管形成,新生血管周围可形成环形骨质沉积. 结论 辛伐他汀可促进异体骨皮质移植后同颈椎椎体的融合.

Effect of simvastatin on the fusion process of cervical intervertebral cortical bone allograft transplantation

Objective To investigate the effect of simvastatin on fusion process after cortical bone allograft transplantation for anterior cervical intervertebral fusion. Methods Forty--four male Wistar rats，undergone anterior cervical discectomy and fusion with allogenous cortical bone transplantation, were divided into 4 groups: control group, simvastatin group, recombinant human bone morphogenetic protein 2(rhBMP-2) group and bland group. The animals of the first 3 groups were sacrificed to obtain cervical spine specimen and performed pathological examination at 2 , 4 , 8 , and 12 week intervals. The bone mineral density of cervical vertebral body was also measured. Results The bone mineral density of control group decreased markedly compared with that of blank group. No difference was found among that of the simvastatin, BMP 2 and blank groups. Inflammatory fibrous capsule existed for a prolonged period and little endochondral calcification in the soft tissue was observed in control group. In both simvastatin and rhBMP-2 groups, bony fusion between the trabecula and the surface of allograft bone was achieved earlier. But in the rhBMP-2 group, fusion was observed only at the surface of the implant. Invasion of soft tissue and new blood vessels into the core region of the implants were apparent in the simvastatin group. And scattered neonate osteons were found within allograft. Conclusion Simvastatin demonstrated the potency of promotin