应用硫酸钙/脱钙骨基质颗粒促进腰椎后外侧融合的临床研究  

The clinical study on the application of calcium sulfate/DBM granule to enhance the instrumented lumbar spine posterolateral fusion

作　　者：谢幼专[1] 张蒲[1] 赵杰[1] 朱振安[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院骨科,上海200011

出　　处：《生物骨科材料与临床研究》2010年第1期20-23,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：国家自然科学基金(30600629);上海市骨科内植物重点实验室建设基金(08DZ2230330);上海教委重点学科建设基金(J50206);上海市浦江人才计划(07pJ14068);上海高校创新团队建设基金资助

摘　　要：目的观察应用硫酸钙/脱钙骨基质颗粒作为植骨替代材料促进腰椎后外侧融合的效果。方法应用硫酸钙/脱钙骨基质颗粒与局部自体骨颗粒混合后进行腰椎后路横突间融合31例。其中男19例,女12例,年龄45～70岁,平均(57.3±9.5)岁。腰椎间盘突出症合并腰椎不稳18例,腰椎滑脱3例,腰椎管狭窄症10例。通过定期X线摄片评估脊柱融合效果。结果术后随访12个月,系列X线平片观察显示硫酸钙/脱钙骨基质颗粒随植入时间的推移逐渐消失,融合节段的横突逐渐出现新骨,最后形成了骨桥。融合节段的Lenke评分随植入时间逐步改善,术后1.5月与3月评分、术后3月与6月评分、术后6月与12月评分有显著性差异(<0.05)。结论应用硫酸钙/脱钙骨基质颗粒与局部自体骨粒混合是一种安全、有效地促进腰椎后外侧融合的方法。Objective To observe the clinical outcome ofposterolateral intertransverse process arthrodesis with calcium sulfate/demineralized bone matrix （DBM） granule in the lumbar spine. Methods Thirty-one patients had undergone lumbar posterolateral intertransverse process arthrodesis with calcium sulfate/DBM granule and local laminectomy bone. There were 19 male and 12 female. The mean age was 57.3 years old （range, 45-70）. There were 18 cases of lumbar disc herniation with lumbar instability, 3 cases of lumbar spondylolisthesis and 10 cases of lumbar stenosis. The roentgeno- graph was evaluated after the operation. Results The patients were followed up consecutively for 12 months. The X films showed that the calcium sulfate/DBM granule disappeared over time and the new bone mass appeared gradually. The Lenke scores were improved with time. There were statistically significant changes on the Lenke score between 1.5-month and 3- month follow-up, between 3-month and 6-month follow-up, between 6-month and 12-month follow-up. Conclusions It is a safe and effective way to enhance the lumbar posterolateral intertransverse fusion with the calcium sulfate/DBM granule.

关 键 词：脊柱融合术 硫酸钙 脱钙骨基质 

分 类 号：R687.3[医药卫生—骨科学]