纳米羟基磷灰石/聚酰胺66椎间融合器用于腰椎退行性疾病手术治疗的初期临床疗效  

Early Clinical Effect of Intervertebral Fusion of Lumbar Degenerative Disease Using Nano-hydroxyapatite/polyamide 66 Intervertebral Fusion Cage

作　　者：杨博[1] 欧云生[1] 蒋电明[1] 安洪[1] 刘渤[1] 张健[1] 李开庭[1] 

机构地区：[1]重庆医科大学附属第一医院骨科,重庆400016

出　　处：《生物医学工程学杂志》2014年第5期1102-1106,共5页Journal of Biomedical Engineering

基　　金：国家高新技术研究发展计划(863)项目资助(2002AA326020);重庆医科大学自然科学基金项目(2012横向课题);重庆市科学技术委员会科技攻关项目资助(csct2012gg-yyjs10018)

摘　　要：为研究纳米羟基磷灰石/聚酰胺66椎间融合器（n-HA/PA66cage）用于腰椎退行性疾病椎间融合术后的初期疗效,回顾性选取2010年8月-2012年1月行后路减压或复位,并植入n-HA/PA66cage融合内固定的腰椎退行性变患者27例,对比术前、术后1周、末次随访时的Oswestry功能障碍指数（ODI）、腰腿痛视觉模拟评分（VAS）及椎间隙高度,并在末次随访时评估骨性融合情况。随访12-24月（平均19月）,ODI术后1周（7.74%±1.65%）和末次随访（7.26%±1.97%）较术前（51.93%±13.62%）有明显改善（P〈0.05）。VAS术后1周[（3.11±1.05）分]和末次随访[（2.96±1.06）分]较术前[（7.07±2.09）分]也明显改善（P〈0.05）。椎间隙高度术后1周[（10.09±1.17）mm]和末次随访[（9.50±0.91）mm]较术前[（7.51±0.56）mm]明显改善（P〈0.05）。但各指标两次术后随访资料比较差异无统计学意义（P〉0.05）。末次随访时用Brantigan的标准评估融合情况,5级融合19例,4级融合8例,无1~3级融合,融合率100%。无cage移位及内固定断裂发生。这些结果表明n-HA/PA66cage用于腰椎退行性疾病的腰后路椎间植骨融合内固定术治疗,是一种较理想的生物材料,可有效维持椎间隙高度,植骨融合率高,早期临床疗效满意。The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage（n-HA/PA66cage）for the treatment of lumbar degenerative diseases.We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012.The oswestry disability index（ODI）,low back and leg pain visual analogue score（VAS）,and intervertebral height（IH）were evaluated at preoperation,1week postoperation and the last follow-up period,respectively.Intervertebral bony fusion was evaluated at the last follow-up time.The patients were followed up for 12-24months（averaged 19months）.The ODI,VAS and IH were significantly improved at 1week postoperation and the last follow-up time compared with those at preoperative period（P〈0.05）.But there was no significant difference between 1week postoperative and the last follow-up time（P〈0.05）.Brantigan＇s standard was used to evaluate fusion at the last follow-up time.There were 19 patients with grade 5fusion,8with grade 4fusion,with a fusion rate of 100%,and none with grade1-3fusions.There was no cage translocation and internal fixation breakage.These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases.It can effectively maintain the intervertebral height and keep a high rate of bony fusion.The early clinical effect has been satisfactory.

关 键 词：腰椎退行性疾病 纳米羟基磷灰石/聚酰胺66椎间融合器 生物材料 

分 类 号：R687.3[医药卫生—骨科学]