同种异体骨移植治疗退行性腰椎滑脱症43例疗效观察  

Evaluation of treatment of degenerative lumbar spondylolisthesis with allogeneic bone graft

作　　者：王丽国[1] 孙立山[1] 冯艳红[1] 李书奎[1] 李民[1] 

机构地区：[1]河北省沧州市中心医院骨1科,河北沧州061001

出　　处：《海南医学院学报》2009年第8期902-904,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020090094)~~

摘　　要：目的:总结同种异体骨移植治疗退行性腰椎滑脱症的疗效。方法:采用冷冻干燥辐照灭菌同种异体骨腰椎间移植治疗退行性腰椎滑脱症43例(实验组),以同期椎间融合器结合脊柱内固定系统治疗退行性腰椎滑脱症37例作为对照组,通过临床观察、X线检查评价疗效,并进行比较。结果:实验组、对照组分别有4例和3例患者出现浅部伤口并发症(P>0.05),分别有8例和4例患者术后体温偏高(P<0.05);随访12～36个月,实验组、对照组优良率分别为88.4%、86.5%,两组差异无统计学意义(P>0.05);实验组术后平均5个月出现了骨愈合,骨性融合率达100%,术后12个月未出现移植骨的吸收;术后X线与最终随访X线片对照,实验组、对照组相对椎间隙高度丢失平均值分别为12.3%、11.9%,两组差异无统计学意义(P>0.05)。结论:冷冻干燥辐照灭菌同种异体骨椎间植骨融合治疗腰椎滑脱症,椎间融合率高,可以较好地维持椎间隙高度,无明显免疫排斥反应,疗效满意。Objective： To evaluate the effect of treatment of degenerative lumbar spondylolisthesis with allogeneie bone graft. Methods： Forty patients with degenerative lumbar spondylolisthesis were treated using bone allograft of freeze-dried irradiation sterilization （group A）, and was compared with 37 patients with degenerative lumbar spondylolisthesis treated at the same period using intervertebral fusion cage system and internal fixation （ group B） , the effects were evaluated aceoding to clinical observation and X - ray examination. Results： Four patients in group A and 3 patients in group B had superficial wound complications, 8 patients in group A and 4 patients in group B with slight higher body temperature after operation, and the differences between the two groups were not significant （P 〈 0.05 ）. According to 12 - 36 months follow-up, the very good and good rate in group A and B was 88.45% and 86.5% respectively, and the difference between the two groups was not significant （P 〉 0. 05 ）. Bone healing time of patients in group A was 5 months by average, bone fusion rate was 100% ; the graftedbones were absorbed at the end of 12th months. According to postoperative X - ray film and the final follow-up X - ray film, the relative average loss of vertebral height were 12.3% and 11.9% in patients of group A and B respectively, and the difference between the two groups was not significant （P 〉 0.05 ）. Conclusion： Treatment of degenerative lumbar spondylolisthesis using bone allograft of freeze-dried irradiation sterilization has satisfactory effect, high interbody fusion rate, maintenance of intervertebral space height, and no significant immune rejection.

关 键 词：同种异体骨 后路腰椎椎间融合 退行性腰椎滑脱症 排异反应 

分 类 号：R681.53[医药卫生—骨科学]