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1 Chinese Journl of Tissue Engineering Reserch August 19, 216 Vol.2, No.34 / ( ). / [J].2162(34): DOI: /j.issn ORCID: () ( 8 ) PLF G1 + G2 +/ G3 + G4 + G5 +/ G6 + G (1) (2)X CT (3) (4) (5) 3 min/d (1)/ (2) (P <.5) :R318 :A : (216) β 2.2 Gs.4 Gs 76.6 Hz 15 Hz 48 L 5/6 6 G1 +G2 +/G3 +G4 + G5 +/G min/d 8 X CT() X G2 G6 (P <.5)G2 G3G5 G6 (P <.5)X G2 (P <.5)CT G2 ISSN CN /R CODEN: ZLKHAH 589

2 . / Zhuo Xing-long, M.D., Associte chief physicin, Mster s supervisor, Deprtment of Spine Surgery, Liuzhou Worker s Hospitl, Liuzhou 5451, Gungxi Zhung Autonomous Region, Chin Corresponding uthor: Hu Jin-zhong, Deprtment of Spine Surgery, Xingy Hospitl of Centrl South University, Chngsh 418, Hunn Province, Chin (P <.5) (P <.5) / ( ) Nno-hydroxyptite coted biphsic clcium phosphte for posterolterl lumbr fusion: combined mgnetic field plys n uxiliry role Zhuo Xing-long 1, Lv Hong-bin 2, Hu Jin-zhong 3, Li Bing 1, Liu Yong 4, Wu Zu-tong 3 ( 1 Deprtment of Spine Surgery, Liuzhou Worker s Hospitl, Liuzhou 5451, Gungxi Zhung Autonomous Region, Chin; 2 Deprtment of Sport Medicine, 3 Deprtment of Spine Surgery, Xingy Hospitl of Centrl South University, Chngsh 418, Hunn Province, Chin; 4 Powder Metllurgy Reserch Institute, Centrl South University, Chngsh 418, Hunn Province, Chin) Abstrct BACKGROUND: Autologous bone is considered the min mteril for spinl fusion, while synthetic mterils overcome the shortcomings cused by the utologous bone (complictions nd limited source) nd become the most promising bone grft substitute mterils. OBJECTIVE: To investigte the effects of nno-hydroxyptite (nno-ha) coting nd combined mgnetic field (CMF) on the biphsic clcium phosphte (BCP) trnsplnttion for rbbit posterolterl lumbr fusion. METHODS: Forty-eight rbbits underwent bilterl intertrnsverse processes fusion t the level of L 5-6, nd were then rndomly divided into six groups: rbbits in group G1 received utologous ilic bone grft nd CMF tretment; group G2 ws given nno-ha/bcp nd CMF tretment; group G3 received BCP nd CMF tretment; group G4 received utologous ilic bone grft nd plcebo; group G5 underwent nno-ha/bcp nd plcebo; group G6 received BCP nd plcebo. CMF tretment ws performed 3 minutes ech dy for 8 consecutive weeks beginning t 1 week fter surgery. These rbbits were euthnized t 9 weeks fter surgery to evlute spinl fusion effects through plption, X-ry exmintion, CT exmintion, histologicl nlysis (declcified nd undeclcified sections) nd biomechnicl ssessment. RESULTS AND CONCLUSION: The plption, X-ry nd histologicl exmintions showed tht there ws significnt difference in the fusion rte between groups G2 nd G6, the highest in the group G2, nd the lowest in the group G6 (P <.5). The bone ingrowth rte in the group G2 ws significntly higher thn those in the groups G3, G4 nd G6 (P <.5). The normlized opticl density index of fusion mss nd bending stiffness in the group G2 were significntly higher thn those in the other groups (P <.5). CT nd histologicl observtions found tht new bone trbecul grew into the biologicl scffold, exhibiting osseointegrtion. Fctoril nlysis showed tht CMF nd nno-ha coting could significntly improve the spinl fusion rte, fusion score, bone ingrowth rte nd bending stiffness (P <.5). In conclusion, CMF combined with nno-ha/bcp for rbbit posterolterl lumbr fusion cn significntly meliorte the fusion rte, which is nlogous to the single utologous bone; therefore, it cn be used s new spinl fusion method. Subject hedings: Lumbr Vertebre; Spinl Fusion; Nnocomposites; Hydroxyptites; Electromgnetic Fields; Tissue Engineering Funding: the Ntionl Nturl Science Foundtion of Chin, No Cite this rticle: Zhuo XL, Lv HB, Hu JZ, Li B, Liu Y, Wu ZT. Nno-hydroxyptite coted biphsic clcium phosphte for posterolterl lumbr fusion: combined mgnetic field plys n uxiliry role. Zhongguo Zuzhi Gongcheng Ynjiu. 216;2(34): P.O. Box 12, Shenyng 1118

3 . / Introduction 3% [1] [2] [3-4] [5-9] [1-11] [12] 1Mterils nd methods PASS 28( α=.5>.8) (2.2±.2) kg () () (Sigm)(Donjoy) MoticImge-pro Plus % (3 mg/kg)l 5 L cm 3 13 min/d 8L 1 S [13] X XFxitron X 7 kv.3 ma15 slopez [14] XHung [15] IPPX (1) =/ CT 4 16 mm.3 mm.4 mm.2 mmu9u7shrp (FOV)5 mm12 kv18 ma s Minics mm1 N.4 mm/s5.5 mm 3 mm/min [16] [17] 1 [18] 6 IPP 6. [19] XCT() 1.6 SPSS 13. ISSN CN /R CODEN: ZLKHAH 591

4 . / WilcoxonKruskl-Wllis LSD WilcoxonKruskl-Wllis LSD α=.5 2Results (2) G2(94%)G6 (44%)2(P=.6)G1 G6(P=.23)G5G3G4 AB (F=.56P=.949)A23% (F=6.747P=.11)B 19% (F=3.513, P=.34) G125G6(P= )G2G4(P=.28) AB (F=.73P=.93)A.33(F=4.667 P=.37)B.38 (F=4.594P=.16) 2.3 X 5 7G1G2 3 9G1 G2G5G3G4G X X2 G1G2G6(P=.23) A B(F=.51P=.95)A( )21% (F=5.12P=.26)B17% (F=2.98P=.6) G1G2G5 G6(P= ) (P >.5)A B(F=.538P=.588)AB.79.75(F=4.521 P=.39F=3.243P=.49) (G1G4) (P <.5) G2G3G5G6 5G3 G2 79(P <.5) 39 G2(P <.5)G3G5G6(P=.9P=.63) AB (P=.835) A 3.15 (P=.)B2.15(P=.8) 2.4 CT CT G1 G4G4X (4AB) G2 (4C)G3G5 G2 (4DE)G6 (4F) 2.53G2 (P <.5)G4 G1G5(P <.5)G5 G6(P <.5) (P >.5)AB (F=1.521P=.68)A() 2.41 N/mm (F=14.12P=.1)B N/mm(F=16.43 P=.) 3G3 (P <.5)G6 592 P.O. Box 12, Shenyng 1118

5 . / 14 1 (n=8) Tble 1 Experimentl niml grouping 12 1 A (2 ) B (3 ) 8 6 / 4 G1 G2 G3 2 G4 G5 G X 1 Figure 2 Comprison of the normlized bsorbnce index of fusion mss by X-ry exmintion mong groups t different Figure 1 Mesurement time points fter surgery of the normlized G1 +G2 + bsorbnce index of /G3 +G4 fusion mss +G5 +/ G X 1 Figure 3 The error br chrt of the normlized opticl density index of fusion 8 mss by X-ry exmintion mong groups t 9 weeks fter surgery 6 G2 G1 +G2 +/ 4 G5 G3 G6 G3 +G4 +G5 + /G6 + A B C 4 9 CT Figure 4 Axil imges of the fusion zone by CT scn in ech group t 9 weeks fter surgery A G1 B G4 C G2 D G5 E G3 F G6 D E F G1 +G2 + /G3 +G4 +G5 +/G G1 G2 G2 G1 4 3 G5 G3 G5 G3 G4 G6 2 2 G4 G6 1 7 ( 7.25±1.16(G1) 7.5±.76(G2) 5.88±1.64(G3) 5 7) 5.87±1.25(G4) 6.5±1.6(G5) 5.25±1.91(G6) Figure 5 The error br chrt of the spinl Figure 7 The interfce between fusion rte by histology in ech group 6 utogenous bone nd rtificil bone G1 +G2 Figure 6 The error br chrt of the spinl (hemtoxylin-eosin stining, 7) +/ fusion score by histology in ech group G3 +G4 G1 +G2 +G5 + +/G3 /G6 +G4 +G5 (MNB +G2 +/G6 CS) G6 P < G1 G4 X (%) ISSN CN /R CODEN: ZLKHAH 593

6 . / S NB NB NB S 8 ( 4) Figure 8 Undeclcified histologicl sections (toluidine blue stining, x4) ()NBS (%) b G2 G3 G5 G6 48.2± ± ± ± G2 G5 G3 G6 9 1 Figure 9 The error br cht of bone ingrowth Figure 1 The error br cht of residul rte rte of the rtificil bone in ech group of the rtificil bone in ech group G2 G356 G3 G2 (P <.5)G3 G6 G6 G5 P < (P <.5) G2 P <.5 G3.5G1 +G2 b P <.5G1 + +/G3 G2 +/ +G4 + G3 +G4 G5 +/ +G5 + G6 + /G6 + 2 X Tble 2 Comprison of spinl fusion evlutions by plption, X-ry nd histologicl exmintion mong groups G1 G2 G3 G4 G5 G6 (n/n) 14/16 15/16 11/16 1/16 12/16 7/16 (x _ ±s) 1.75± ± ± ± ±.53.88±.64 X (n/n) (x _ ±s) 14/ ±.64 14/ ±1.4 1/16 4.±.93 1/ ±1.4 11/16 4.5±1.2 7/16 3.±2.27 (n/n) 7/8 8/8 5/8 4/8 6/8 3/8 (x _ ±s) 7.25± ± ± ± ± ±1.91 G1 +G2 +/G3 +G4 + G5 +/G6 + X n=n= n= N= 3 (x _ ±s) Tble 3 Comprison of results in three-point bending test mong groups (N/mm) (MP) (N) G ± ± ±52.13 G ± ± ±47.82 G ± ± ±38.83 G ± ± ±4.25 G5 18.5± ± ±32.17 G ± ± ±25.37 G1 +G2 +/G3 +G4 + G5 +/G6 + (%) (P <.5)G2 G1G4G5(P <.5) G1G4G5(P >.5) (P <.5) G2 G6(P=.29) (P >.5) A B (F=.18, P=.898)A29% (F =5.277, P=.27)B 25%(P=.6) 6G2 594 P.O. Box 12, Shenyng 1118

7 . / G3G4G6(P <.5)G1G6 (P=.8)(P >.5)AB (F=.272, P=.763) A 1.(F=5.81P=.2)B.96(F=4.26, P=.22) (7) (8) G2 G6 G3G5G6 5% G2 (P <.5)G6G3 (P <.5)G5(P=.54)A B (P=.1)(9) IPP (1)G238% G3G6(P <.5) (P >.5)A (P=.13)B (P=.3) 3Discussion Linovitz [2] RCT 9 64% 43%(P=.3) Mrks [21] 23%B 19% (F=6.747P=.11F=3.513P=.34) +/ (94%)(63%) +(88%) Ito [22] CT G2 / G2 / [19] [23] G2 (G3G5 G6 ) ISSN CN /R CODEN: ZLKHAH 595

8 . / G2 G3G5 G6 (P=.2.2.) G6 G4 G5 (P=.39P=.52) (P=.1) +/ Fini [24-25] CT G2 G3 G5 G6 CT 12%(P <.5) 6%(P >.5) Glzer [26] 1 6 (35%)(37%) (42%) Glzer G2 (P <.5)G5 G4 G6 (P <.5)G1 G4 (P <.5) 2.41 N/mm(F=14.12P=.1) 23.85% (F=16.43P=.) G3 (P <.5)G6 (P <.5)G2 G1G4 G5 (P <.5) G1G4 G5 (P >.5) (P <.5) 2 mm / / 29 Ethicl issues in niml experimenttion CNKI 3 () 596 P.O. Box 12, Shenyng 1118

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