自制异体骨垫与自体髂骨在颈椎前路椎间植骨融合中的比较  

Comparative analysis of allogeneic bone pad and autogenous bone graft in anterior cervical interbody fusion

作　　者：汪伟基[1] 关玉成[1] 高希林 季明华[1] 郭树章[1] 范相成[1] 叶斯波[1] 

机构地区：[1]解放军兰州军区乌鲁木齐总医院创伤骨科,新疆维吾尔自治区乌鲁木齐市830000

出　　处：《中国组织工程研究》2014年第39期6252-6257,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:颈椎骨折诊断后多需手术治疗,前路椎体间植骨融合技术仍是目前治疗颈椎退行性或创伤性不稳的主要方法。作者设计的椭圆形同种异体骨垫,可以适应不同高度及宽度椎间隙的需要,符合椎间隙的生理形状。目的:通过与自体髂骨比较,评价自制同种异体骨垫在颈椎前路椎间植骨融合中的疗效。方法:2009年1月至2013年6月对58例颈椎椎间盘突出患者行前路一期椎间盘切除、椎间植骨融合内固定治疗,根据植骨材料不同,分为同种异体骨垫组和自体髂骨组,病程12-24个月。治疗后评价指标包括日本骨科协会(JOA)评分、颈椎间隙融合率、融合时间、手术时间、术中出血及排斥反应。结果与结论:治疗后6个月两组患者JOA评分差异无显著性意义(P>0.05)。治疗后6个月同种异体骨垫组、自体髂骨组治疗后有效融合率分别为84%和88%,差异无显著性意义(P>0.05)。同种异体骨垫组植骨融合时间较自体髂骨组长,差异有显著性意义(P<0.05)。两组内固定物均牢靠无松动,随访期间均无植骨排斥。提示与自体髂骨相比,同种异体骨垫在颈椎前路植骨融合中疗效满意,可有效融合病变椎间隙,且异体骨垫不会产生因取骨引起的取骨区疼痛等不适。BACKGROUND：Surgical treatment is often required for fractures of the cervical vertebrae. Anterior interbody fusion technology is stil the main method for the treatment of cervical degeneration or traumatic instability. Here, the self-made oval al ogeneic bone pad can adapt to different height and width of the intervertebral space, in line with the physiological shape of the intervertebral space. OBJECTIVE：By comparison with autogenous iliac crest bone, to evaluate various types of self-designed al ogeneic bone pads on anterior cervical interbody fusion. METHODS：From January 2009 to December 2013, 58 patients with cervical disc herniation were enrol ed and subjected to cervical discectomy and anterior cervical interbody fusion. According to different bone grafts, these patients were divided into al ogeneic bone pad and autogenous iliac bone groups. The course of disease was 12 to 24 months. The postoperative effect was measured by Japanese Orthopaedic Association （JOA） score, cervical fusion rate, fusion time, operative time, blood loss and rejection rate. RESULTS AND CONCLUSION：At 6 months postoperatively, the JOA score of two groups had no significant difference at 6 months after treatment （P〉0.05）;the cervical fusion rates were 83.7%and 87.8%, respectively, in the al ogeneic bone pad and autogenous iliac bone groups, with no significant difference （P〉0.05）. Fusion time was higher in the al ogeneic bone pad than in the autogenous iliac bone group （P〈0.05）. The internal fixators in the two groups were firmed without loosening, and there was no rejection during the fol ow-up. Compared with the autogenous iliac crest bone, anterior cervical interbody fusion with al ogeneic bone pad can achieve satisfactory effects, which can be better for intervertebral fusion and cannot induce pain due to bone cutting.

关 键 词：生物材料 骨生物材料 自制异体骨垫 自体髂骨 颈椎融合 内固定 

分 类 号：R318[医药卫生—生物医学工程]