Palkin O. Evaluation of development of bone block after lumbar intertransverse process fusion using different transplantats (clinical and experimental study).

Object: the process of forming a bone block in the case of the lumbar posterolateral fusion in experimental animals (rabbits). Aim: improving of the assessment of the bone formation after the lumbar posterolateral fusion using various osteoplastic materials based on experimental, clinical and radiological studies. Methods: experimental model, radiology, computer tomography, morphology, biochemistry, clinical, statistical. For the first time in the in vivo experiment, the formation of the bone block was demonstrated in 64.3 % of observations after experimental lumbar mono-segmental intertransverse fusion using bone allo- and local autografts isolated and in combination with autologous platelets rich fibrin. For the first time, an increase in the reparative potential of the osteoplastic material (auto- and allobone) in the area of fusion in combination with autologous platelets rich fibrin has been established. The dynamics of markers of mineral metabolism and connective tissue metabolism in serum of rabbits before and after lumbar intertransverse fusion using different osteoplastic materials has been studied for the first time, and a significant increase in the concentration of glycoproteins, chondroitin sulfates and β-lipoproteins has been observed, which reflects the active formation of the organic bone tissue matrix in the fusion zone. For the first time, the comparison of the results of radiological (including X-ray), histological and biochemical studies on rabbits during the formation of bone regenerate in the fusion zone has been determined. The feasibility of using an osteoplastic material when carrying out intertransverse fusion, which combines allo-or local autografts with autologous platelets rich fibrin, has been experimentally substantiated, contributing to the formation of mature bone tissue in the area of union. The clinical testing confirmed the osteogenic properties of the specified biomaterial. The use of the comprehensive evaluation of the results of experimental intertransverse fusion on rabbits (review X-ray with a test object for standardization of the optical density of vertebral structures, morphological data on the state of regenerate, and biochemical studies of the content of mineral metabolism and exchange of connective tissue in serum of rabbits) in the experiment allows to characterize the quality, the number, the maturity of the newly formed bone tissue. The results of the dissertation were introduced into the scientific and clinical work of the SI “Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine”, in the scientific process of the Department of Traumatology and Orthopedics of the Kharkiv National Medical University of the Ministry of Health of Ukraine. Тraumatology and Orthopaedics.