零切迹自锁椎间融合器联合rhBMP-2融合术应用于ACDF的疗效分析  

Curative effect analysis of rhBMP-2 combined with Zero-P interbody fusion system used in ACDF

作　　者：许春财[1] 徐杨[1] XU Chuncai;XU Yang(Department of Orthopedics,Fujian Provincial Hospital,Fuzhou,Fujian 350001,China)

机构地区：[1]福建省立医院骨一科,福建福州350001

出　　处：《现代医药卫生》2018年第24期3757-3759,3762,共4页Journal of Modern Medicine & Health

基　　金：福建省科技厅自然科学基金项目(2016J01505)

摘　　要：目的探讨零切迹自锁椎间融合器联合重组人骨形态发生蛋白-2(rhBMP-2)融合术在前路颈椎间盘切除椎间融合术(ACDF)中的临床疗效。方法 2014年6月至2017年6月因单节段颈椎病在该院行ACDF治疗的患者74例,25例行颈前路椎间盘切除常规椎间融合器钛板固定术(A组),27例行颈前路椎间盘切除零切迹自锁椎间融合器融合术(B组),22例行零切迹自锁椎间融合器联合rhBMP-2融合术(C组)。记录手术时间、术中出血量、术后引流量、术后吞咽困难发生情况,采用日本矫形外科协会治疗评分(JOA评分)、视觉模拟疼痛评分(VAS评分)及术后各时间点融合率评价临床疗效。结果 B、C组手术时间、术中出血量、术后引流量均少于A组(P<0.05),B、C组间比较差异无统计学意义(P>0.05)。A、B、C组术后1、3、12个月JOA评分、VAS评分均较术前明显改善(P<0.05),各时间点各组间JOA、VAS评分比较差异无统计学意义(P>0.05)。B、C组术后吞咽困难发生率低于A组(P<0.05),B、C组间比较差异无统计学意义(P>0.05)。C组术后3、6个月融合率高于A、B组(P<0.05),A、B组间比较差异无统计学意义(P>0.05)。结论 ACDF中采用零切迹自锁椎间融合系统疗效与传统融合固定相当,且具有手术时间短、术中出血少、术后引流少、术后吞咽困难发生率低等优点,联合使用rhBMP-2还能促进早期融合,提高融合手术成功率。Objective To investigate curative effect of recombinant human bone Morphogenetic protein-2(rhBMP-2)combined with Zero-P interbody fusion system used in anterior cervical discectomy fusion(ACDF).Method s74 cases withcervical spondylopathy admitted to this hospital from Jun. 2014 to Jun. 2017 were divided into three groups according to the op-eration method,including group A(25 cases)treated by anterior discectomy and fixation by intervertebral fusion cage and titani-um plate,group B(27 cases)treated by anterior discectomy and fixation Zero-P intervertebral fusion cage,group C treated byanterior discectomy and fixation Zero-P intervertebral fusion cage with rhBMP-2. Operative time,blood loss,drainage volume,incidence of dysphagia,preoperative and postoperative Japanese Orthopaedic Association score(JOA score)and visual analogscale(VAS)pain score and fusion rate were compared to evaluate the clinical effects.Results The operative time,blood lossand drainage volume in group B and C were less than group A(P<0.05). The postoperative JOA and VAS pain score were signif-icantly higher than preoperative score in each group(P<0.05),while there were no significant difference at the same time pointamong the three groups(P>0.05). The incidence of dysphagia of group B and C was significantly lower than group A(P<0.05),while there was no significant difference between group B and C(P>0.05). The fusion rates of group C at 3 months and 6 monthsafter operation were significantly higher than group A and B(P<0.05),while there was no significant difference between groupA and B(P>0.05).Conclusion Zero-P interbody fusion system used in ACDF could have the effects comparable to traditionalmethods and could be with more advantages of operation time,blood loss,drainage volume and incidence of dysphagia.Combine with rh BMP-2 could promote early fusion,thus improve clinical curative effect.

关 键 词：颈椎病 椎间融合器 重组人骨形态发生蛋白-2 脊柱融合 

分 类 号：R687.3[医药卫生—骨科学]