一体成形式皮质骨生物椎间融合器临床应用26例随访  

Clinical application of forming one cortical biological fusion cage:Follow up of 26 cases

作　　者：吕浩然[1] 杨进顺[1] 黄文铎[1] 史群伟[1] 

机构地区：[1]广州医学院第二附属医院骨外科,广东省广州市510260

出　　处：《中国组织工程研究与临床康复》2007年第44期8923-8925,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：广州医学院博士启动资金资助(2006GD074);广东省科技计划项目(2006B35801005)~~

摘　　要：目的:观察一体成形式皮质骨生物椎间融合器应用于腰椎后路减压植入术中的效果,并分析其生物学特点。方法:2005-08/2007-01广州医学院第二附属医院对26例腰椎疾病患者行后路减压一体成形式皮质骨生物椎间融合器植入术,术后随访≥6个月,平均10.1个月。所有患者均于术前、术后拍摄腰椎正、侧位片及过伸过屈位片,随访时摄同体位片,观察手术的椎体间棘突有无运动,局部有无透亮带或骨小梁形成;同时监测腰椎间隙高度变化及腰椎生理前凸角度的变化,以了解融合器骨性愈合情况,评估标准为术后椎间隙高度持续随访无降低及腰椎前凸角度不变则融合器骨性愈合。结果:①26例患者末次随访时均获得骨性融合,融合率为100%;21例患者的临床疗效为优良,5例患者为良好,无疗效为差的病例;无术中及术后并发症产生。②术后及末次随访椎间隙高度与术前相比明显增加(P<0.01),术后椎间隙高度与末次随访比较无明显变化(P>0.05)。③术后及末次随访腰椎生理前凸(Cobb角)与术前相比明显增大(P<0.01),术后腰椎生理前凸与末次随访比较无明显变化(P>0.05)结论:一体成形式皮质骨生物椎间融合器具有早期的制动作用,可有效维持脊椎的生理弧度和椎间隙的高度,提供初始及中间时期的稳定性以实现骨性融合,并能有效防止下沉,稳定融合节段及便于判断融合的特点。AIM. To observe the clinical effect of forming one cortical biological fusion cage （FOCBFC） in the posterior decompression and implantation, and analyze its biological characteristics. METHODS. From August 2005 to January 2007, twenty-six patients with lumbar spondylotic myelopathy were treated by posterior decompression and implantation of FOCBFC in the Second Hospital affiliated to Guangzhou Medical College. All patients were followed up for an average of 10.1 months （≥6 months）. Before and after operation, all patients were taken X-ray photograph by hyperextension and hyperflexion pose. The movement of spinous process, trabecula of bone, and radiolucent zone were observed. Simultaneously, the intervertebral height and lumbar lordosis changes were monitored so as to explore the fusion cage synostosis. No change of intervertebral height and lumbar lordosis suggested fusion cage synostosis. RESULTS. ①Twenty-six patients all achieved bone fusion within the follow-up period; the fusion rate was 100%. Twenty-one of them were found to have excellent outcome, and 5 were found good outcome; no complication encountered. ②Post-operation and the last follow-up X-ray photograph of intervertebral height was significantly increased compared with that before operation （P 〈 0.01 ）, but no changes were found between the height after operation and the last follow up （P 〉 0.05）. ③The lumbar lordosis （Cobb angle） post-operation and the last follow-up was remarkably increased compared with that pre-operation （P 〈 0.01）, but no changes were found between the height after operation and the last follow up （P 〉 0.05）. CONCLUSION： FOCBFC can effectively maintain the physiological vertebral lordosis and the disk space height, provide initial and intermedia stability to achieve bone fusion, effectively prevent subsidence and stabilize the fusion segment. Easy assessment of fusion is another characteristic.

关 键 词：脊柱融合 可吸收材料 椎间融合器 

分 类 号：R318[医药卫生—生物医学工程]