Objective To observe the ability to repair bilateralradius bone defect with the composite of β-tricalciumphosphate(βTCP),hyaluronic acid(HA),type I collagen(COL-Ⅰ) and induced marrow stromal cells(MSCs), and to investigate the feasibility of the composite as a bone substitute material.Methods The MSCs of the New Zealand white rabbits were induced into ostoblasts, then combined with β-TCP, HA and COL-Ⅰ. Thirty New Zealand white rabbits were made the bilateral radius bone defects of 2 cm and divided into groups A, B and C. After 8 weeks, β-TCP-HA-COL-Ⅰ-MSCs （group A, n=27 sides）, autograft （group B, n=27 sides）andno implant（group C as control, n=6 sides）were implanted into the areas ofbilateral radius bone defects, respectively. The structure of the composite was observed by scanning electron microscope. The repairing effect was observed by gross, histomorphology, X-ray examination, and the degradation rate of inorganic substance at 4, 8 and 12 weeks. The ostogenic area and biomechanics ofgroup A were compared with those of group B at 12 weeks.Results The MSCs could stably grow in vitro, relatively rapidly proliferated, and could be induced into the ostoblasts.The composite was porous. The results of gross, histomorphology and X-ray showed that the bone defects were perfectly repaired in group A and group B, but not in group C. The ostogenic area or biomechanics had no statistically significant difference between groups A and B(Pgt;0.05). The weight of inorganic substance in group A were 75% ,57% and 42% at 4,8,12 weeks, respectively.Conclusion MSCs can be used as seedcells in the bone tissue engineering. The composite has porous structure, no reactions of toxicity to the tissue and rapid degradation, and it is an ideal carrier of seed cells.The β-TCP-HA-COL-Ⅰ-MSCs composite has the high ability of repairing bone defect and can serve as an autograft substitute material.
ObjectiveTo investigate the effectiveness of sagittal top compression reduction technique in the treatment of thoracolumbar vertebral fractures. Methods A retrospective analysis was conducted on the clinical data of 59 patients with thoracolumbar vertebral fractures who met the selection criteria and were admitted between November 2018 and January 2022. Among them, 34 patients were treated with sagittal top compression reduction technique (top pressure group), and 25 patients were treated with traditional reduction technique (traditional group). There was no significant difference in baseline data between the two groups (P>0.05), including gender, age, fracture segment, cause of injury, AO classification of thoracolumbar vertebral fractures, thoracolumbar injury classification and severity (TLICS) score, American Spinal Injury Association (ASIA) grading, surgical approach, preoperative vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, segmental kyphosis angle, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and incidence of complications between the two groups were recorded and compared. After operation, VAS score and ODI were used to evaluate effectiveness, and X-ray and CT examinations were performed to measure imaging indicators such as vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, and segmental kyphosis angle. ResultsThere was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. Patients in both groups were followed up 6-48 months, with an average of 20.6 months. No loosening, breakage, or failure of internal fixation occurred during follow-up. The imaging indicators, VAS score, and ODI of the two groups significantly improved at 1 week and last follow-up when compared to preoperative ones (P<0.05). At last follow-up, the VAS score and ODI further significantly improved when compared to 1 week after operation (P<0.05). At 1 week after operation and last follow-up, the vertebral body index, segmental kyphosis angle, injured vertebra angle, and ODI in the top pressure group were significantly better than those in the traditional group (P<0.05). There was no significant difference in VAS score and height ratio of the anterior margin of injured vertebra between the two groups at 1 week after operation (P>0.05), but the two indicators in the top pressure group were significantly better than those in the traditional group at last follow-up (P<0.05). Conclusion The treatment of thoracolumbar vertebral fractures with sagittal top compression reduction technique can significantly improve the quality of vertebral reduction, and is superior to traditional reduction techniques in relieving pain and improving spinal function.