Osteoset人工骨加自体骨移植治疗胸腰椎脊柱结核：与自体骨移植的比较  

Osteoset artificial bone combined with autogeneic bone grafting for the treatment of thoracic-lumbar spinal tuberculosis: Compared with autogeneic bone grafting alone

作　　者：李坛珠 刘浩[2] 张闻力[2] 宋跃明[2] 龚全[2] 李涛[2] 刘立岷[2] 

机构地区：[1]日喀则地区人民医院骨科,西藏自治区日喀则地区857000 [2]四川大学华西医院骨科,四川省成都市610041

出　　处：《中国组织工程研究与临床康复》2008年第1期85-88,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然科学基金项目(30572163)~~

摘　　要：目的:分析病灶彻底清除后Osteoset人工骨加自体骨移植联合内固定治疗脊柱结核的安全性、可行性和治疗效果,并与单纯使用自体骨植骨比较。方法:①实验对象:2003-01/2005-11在四川大学华西医院骨科手术治疗的脊柱结核患者124例,随机选择40例胸腰椎脊柱结核患者进行分析,对治疗和实验均知情同意。②实验材料:Osteoset-T人工替代骨:由美国瑞特(Wright)医疗技术公司生产的骨移植替代材料。③实验方法:实验组20例,病灶彻底清除后带妥布霉素的Osteoset人工骨加自体骨植骨内固定对照组20例,病灶彻底清除后单纯自体骨植骨内固定。④实验评估:根据术前、术后、术后3个月、术后6个月、术后1个月患者脊柱X射线正侧位片及CT扫描对两组患者的骨融合和畸形矫正情况进行评定和分析。结果:①患者平均住院19.5d(12～27d)。所有患者术后伤口均一期愈合,无全身并发症状,术后1周平均白细胞计数8.×109。②随访12～48个月,平均26个月。影像学资料提示钢板位置良好,内固定无松动;结核病灶均无复发,脊柱后凸畸形平均矫正Cobb角15°,畸形矫正角度没有丢失。③Osteoset人工骨加自体骨植骨术后3个月融合率为40%(8/20);术后6个月融合率为85%(17/20),单纯自体骨植骨术后3个月融合率为10%(2/20例),术后6个月达55%(11/20)。术后1年两组的融合率均为100%。结论:Osteoset人工骨在胸腰椎脊柱结核骨融合术中可以补充植骨量。AIM： To assess the reliability, feasibility and superiority of Osteoset artificial bone and autogeneic bone grafting after radical debridement in the treatment of spinal tuberculosis, and compare with autogeneic bone grafting alone. METHODS： （1）Totally 124 patients with spinal tuberculosis underwent surgery in the Department of Orthopedics, West China Hospital of Sichuan University from January 2003 to November 2005, and 40 cases with thoracic-fumbar spinal tuberculosis were selected as analysis subjects, with their informed consents for the treatments and trials.（2）Osteoset artificial bone was produced by American Wright Medical Technology, Inc.（3）Experimental group （n =20） underwent radical debridement, then Osteoset artificial bone with tenebrimycin and autogeneic bone grafting, in combination with internal fixation; Control group （n=20） underwent radical debridement, then bone autograft combined with internal fixation.（4）Radiographs （X-rays and CT scans） were conducted before operation, immediately after operation, 3 months, 6 months and 12 months after operation to access bony fusion and deformity correction of the patients. RESULTS： （1）The average in-patient days was 19.5 days （12 -27 days）. All the patients acquired satisfactory, incision healing without complication. The average white blood cell account one week after operation was 8.2 ×10^9.（2）The follow-up period ranged from 12 to 48 months （mean 26 months）. There was no recurrence of the disease or looseness of internal fixation. Kyphosis correction was achieved by 15° on the average Cobb＇s angle（3）Tbe rate of bonc fusion in experimental group was 40% （8/20） 3 months after operation and 85% （17/20） 6 months after operation. While that in control group was 10% （2/20） 3 months after operation and 55% （11/20） 6 months after operation. Both groups realized 100% fusion 1 year after operation. CONCLUSION： Osteoset artificial bone can recruit bone graft mass during the bone fusion for

关 键 词：脊柱结核 人工骨 自体骨 内固定 移植 

分 类 号：R318.08[医药卫生—生物医学工程]