同种异体骨板覆盖预防椎板切除术后硬膜外粘连临床应用  

Clinical application of allogeneic bone plate coverage for prevention of epidural adhesion after laminectomy

作　　者：杨述华[1] 李宝兴[2] 唐欣[1] 许伟华[1] 李进[1] 杨操[1] 叶哲伟[1] 孙世荃[2] 张育敏[2] 康悦[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,湖北武汉430022 [2]中国辐射防护研究院山西省医用组织库,山西太原030000

出　　处：《临床骨科杂志》2005年第6期481-483,共3页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金资助项目(编号:30471753)

摘　　要：目的探讨同种异体骨板覆盖在预防椎板切除术后硬膜外粘连方面的疗效.方法对58例腰椎间盘突出或腰椎管狭窄患者,行全椎板切除,'H'形同种异体冻干辐照骨板覆盖.观察临床症状及CT、MRI表现.结果术后随访6个月～2.5年,CT、MRI椎管扩大,骨板无倾斜、移位,脊髓无压迫,无排异反应;术后椎管内容物形态良好,骨板两侧已与相邻接触骨组织融合,密度相等.结论同种异体冻干辐照骨板具有良好的生物相容性、生物力学性能和诱导成骨作用,是一种良好的硬膜外覆盖材料,能有效阻止硬膜外粘连,防止椎管术后再狭窄,可用于节段性椎管覆盖成型术.Objective To investigate the effect of allogeneic bone plate coverage for prevention of epidural adhesion after laminectomy. Methods 58 cases with lumbar disc herniation or lumbar stenosis were treated with total laminectomy and “H” allogeneic freezed drying radiated bone plate coverage. The manifestation and CT, MRI films were study postoperatively. Results All cases were followed up for 6 - 30 months. CT and MRI showed the lumbar canals were expanded, and no bone plate tilt, displacement, spinal cord compression or resisted reaction was found. The contours of elements in spinal canal were good, and the bone plate fused with the adjacent bone bilaterally with identical densities. Conclusions Allogeneic freezed drying radiated bone plate has good biocompatibility, biomechanical properties and bone inductivity, which is a good material for epidural coverage. It is effective to prevent epidural adhesion and spinal canal restenosis, so it can be used in segmental coverage laminoplasty.

关 键 词：椎板切除术 移植 同种骨板 硬膜粘连 手术后并发症 

分 类 号：R687.3[医药卫生—骨科学] R619.9[医药卫生—外科学]