钛质外科网和纳米仿生骨在颈椎前路减压融合中的应用  

A comparison between titanium surgical mesh and bionic nano-bone in anterior cervical decompression and fusion

作　　者：杨朝垒[1] 王利民[1] 刘屹林[1] 谭宏宇[1] 王卫东[1] 

机构地区：[1]郑州大学第一附属医院骨科,河南省郑州市450052

出　　处：《中国组织工程研究与临床康复》2011年第3期413-416,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家科技支撑计划课题--活性纳米复合生物材料制品手术示范与临床应用(2007BAE13B00)~~

摘　　要：背景：纳米羟基磷灰石/聚酰胺作为新型植骨材料,应用于颈椎前路减压融合中,不仅可以减少患者取骨带来的并发症,而且具有稳定的植骨融合率。目的：比较钛网和纳米羟基磷灰石/聚酰胺应用于颈椎前路减压融合治疗脊髓型颈椎病的临床效果。方法：对确诊的48例脊髓型颈椎病患者行颈前路椎体次全切减压融合钛板内固定。其中26例行钛网植骨,22例行纳米羟基磷灰石/聚酰胺仿生骨植骨,采用JOA评分法评价神经功能的恢复,测量cobb角评价融合节段曲度。结果与结论：48例患者均获得随访,随访时间6-14个月。置入后3个月JOA评分较置入前明显改善,两组对比JOA评分差异无显著性意义;置入后3,6个月钛网组及仿生骨组融合节段cobb角相对于置入后即刻变化差异有显著性意义,两组对比差异无显著性意义;置入后3个月钛网组2例患者出现钛网沉降,融合节段椎间高度丢失。结果表明纳米羟基磷灰石/聚酰胺仿生骨作为颈椎前路融合植骨材料,融合率高,可以有效保持颈椎生理曲度及椎间高度,长期效果有待进一步观察。BACKGROUND： Nano-hydroxyapatite/polyamide as a new bone graft material is used in anterior cervical decompression and fusion, it not only reduces the complications after bone removal, and exhibits a stable graft fusion rate. OBJECTIVE： To study clinical effect of titanium surgical mesh versus nano-hydroxyapatite and polyamide composite （n-HA/PA66） in anterior cervical decompression and fusion for treatment of cervical sondylotic myelopathy. METHODS： A total of 48 cases of cervical spondylotic myelopathy were treated with anterior cervical subtotal corpectomy and fusion, titanium locking plates fixation, 26 with titanium surgical mesh, 22 with n-HA/PA66. The JOA grading system was done to evaluate neural functional restoration, and Cobb’s angle was measured to evaluate the change of cervical curvature. RESULTS AND CONCLUSION： All 48 patients were operated successfully and followed up for 6-14 months. The JOA grading scores were greatly improved in both groups at 3 months postoperation compared with before operation, without significant differences between two groups; at 3 and 6 months postoperation, the Cobb’s angle of all patients had significant differences compared with immediately after operation, without significant differences between two groups; 2 cases were evidenced subsidence of titanium surgical mesh and loss of vertebral height after three months of operation. N-HA/PA66 bionic bone as a graft of anterior cervical fusion has good fusion rate, and could effectively maintain the biological alignment and cervical intervertebral height. The long-term effects depend on further follow-up.

关 键 词：颈椎病 钛质外科网 纳米羟基磷灰石/聚酰胺 前路植骨融合 生物相容性 

分 类 号：R318[医药卫生—生物医学工程]