Background. Vertebral bone defect represents one of the most commonly found skeletal problems in the spine. Progressive increase of vertebral involvement of skeletal tuberculosis (TB) is reported as the main cause, especially in developed countries. Conventional spinal fusion using bone graft has been associated with donor-site morbidity and complications. We reported the utilization of umbilical cord mesenchymal stem cells (UC-MSCs) combined with hydroxyapatite (HA) based scaffolds in treating vertebral bone defect due to spondylitis tuberculosis. Materials and Methods. Three patients with tuberculous spondylitis in the thoracic, thoracolumbar, or lumbar region with vertebral body collapse of more than 50 percent were included. The patient underwent a 2-stage surgical procedure, consisting of debridement, decompression, and posterior stabilization in the first stage followed by anterior fusion using the lumbotomy approach at the second stage. Twenty million UC-MSCs combined with HA granules in 2 cc of saline were transplanted to fill the vertebral bone defect. Postoperative alkaline phosphatase level, quality of life, and radiological healing were evaluated at one-month, three-month, and six-month follow-up. Results. The initial mean ALP level at one-month follow-up was . This value increased at the three-month follow-up but decreased at the six-month follow-up time, and , respectively. Bone formation of 50-75% of the defect site with minimal fracture line was found. Increased bone formation comprising 75-100% of the total bone area was reported six months postoperation. A total score of the SF-36 questionnaire showed better progression in all 8 domains during the follow-up with the mean total score at six months of from all patients. Conclusion. Umbilical cord mesenchymal stem cells combined with hydroxyapatite-based scaffold utilization represent a prospective alternative therapy for bone formation and regeneration of vertebral bone defect due to spondylitis tuberculosis. Further clinical investigations are needed to evaluate this new alternative.

中文翻译：

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脐带间充质干细胞在羟基磷灰石支架治疗结核性脊柱炎椎骨缺损中的应用整合：一项转化研究

背景。椎骨缺损是脊柱中最常见的骨骼问题之一。据报道，骨骼结核（TB）椎体受累的逐渐增加是主要原因，尤其是在发达国家。使用骨移植的传统脊柱融合术与供体部位的发病率和并发症有关。我们报道了脐带间充质干细胞 (UC-MSCs) 联合羟基磷灰石 (HA) 支架治疗结核性脊柱炎引起的椎骨缺损的应用。材料和方法. 纳入 3 例胸椎、胸腰椎或腰椎结核性脊柱炎患者，椎体塌陷率超过 50%。患者接受了两阶段的外科手术，包括在第一阶段清创、减压和后路稳定，然后在第二阶段使用腰部切开入路进行前路融合。移植了 2000 万个 UC-MSCs 与 HA 颗粒在 2 cc 的盐水中以填充椎骨缺损。在 1 个月、3 个月和 6 个月的随访中评估术后碱性磷酸酶水平、生活质量和放射愈合情况。结果。1 个月随访时的初始平均 ALP 水平为. 该值在随访 3 个月时增加，但在随访 6 个月时下降，和，分别。发现有 50-75% 的缺损部位骨形成，骨折线最小。据报道，术后 6 个月，骨形成增加，占总骨面积的 75-100%。SF-36 问卷的总分显示，在随访期间所有 8 个领域的进展都更好，平均总分在 6 个月来自所有患者。结论。脐带间充质干细胞与基于羟基磷灰石的支架利用相结合，代表了一种前瞻性的替代疗法，用于骨形成和结核性脊柱炎引起的椎骨缺损的再生。需要进一步的临床研究来评估这种新的替代方案。