自体骨与骨形态蛋白修复青年腰椎峡部裂比较  

Bone autograft only versus bone autograft combined with bone morphogenetic protein for repairing lumbar spondylolysis in young adult

作　　者：赵广民 孟浩 王俊峰[1] 张志成[1] 关凯 任大江[1] 李放 ZHAO Guang-min;MENG Hao;WANG Jun-feng;ZHANG Zhi-cheng;GUAN Kai;REN Da-jiang;LI Fang(The First Orthopedic Department,The Seventh Medical Center,General Hospital of PLA,Beijing100700,China)

机构地区：[1]解放军总医院第七医学中心骨一科,北京100700

出　　处：《中国矫形外科杂志》2020年第19期1752-1756,共5页Orthopedic Journal of China

摘　　要：[目的]比较单纯自体与自体骨混合骨形态蛋白(BMP)原位植入修复青年腰椎峡部裂的临床效果。[方法]回顾分析2015年1月~2019年6月,本科手术治疗的80例腰椎峡部裂患者。原位清创后,40例于峡部单纯植入自体骨,40例植入自体骨混合BMP,均给予节段间椎弓根钉固定。比较两组患者围手术期、随访和影像资料。[结果]两组患者均顺利完成手术,均无严重并发症。随访18个月以上,随时间推移,两组患者VAS和ODI评分均显著减少(P<0.05);相应时间点,两组间VAS和ODI评分的差异均无统计学意义(P>0.05)。影像方面,随时间推移,两组患者峡部愈合率均显著增加(P<0.05)。术后3、6和12个月时,BMP组的峡部骨性愈合率显著高于自体骨组(P<0.05);术后18个月,BMP组的峡部骨性愈合率仍高于自体骨组,但差异已无统计学意义(P>0.05)。[结论]青少年腰椎峡部裂采用峡部原位自体髂骨植骨合并BMP可以有效促进峡部骨愈合。[Objective]To compare the clinical outcomes of bone autograft only versus bone autograft combined with bone morphogenetic protein(BMP)for in-suit repairing of lumbar spondylolysis in young adult.[Methods]From January 2015 to June 2019,80 young patients underwent surgical treatment for simple lumbar spondylolysis in our hospital.Of them,40 patients had bone autograft only filled into the isthmic gap of spondylolysis after debridement(the BA group),while the remaining 40 patients had bone autograft combined with BMP inserted into the gap(the ba-BMP group),followed by pedicles screw fixation of the spondylolysis segment conducted in both groups.The perioperative,follow-up and radiographic documents were compared between the two groups.[Results]All patients in both groups had operation performed smoothly without serious complications in anyone of them.As time went during follow-up period lasted for more than 18 months,both the VAS and ODI scores significantly decreased in the two groups(P<0.05),nevertheless no statistical differences in the VAS and ODI scores were proved at any matching time point between the two group(P>0.05).With regard to imaging evaluation,the isthmic bony healing rate significantly increased over time in both groups(P<0.05).The ba-BMP group proved superior to the BA group in the isthmic bony healing rate,which were of statistical significance at 3,6 and 12 months postoperatively(P<0.05),while became not statistically significant at 18 months after operation between the two group(P>0.05).[Conclusion]It is effective to improve the isthmic bony healing that bone autograft combined with bone morphogenetic protein is implanted for in-suit repairing of lumbar spondylolysis in young adult.

关 键 词：青年 腰椎峡部裂 自体骨植骨 骨形态蛋白 

分 类 号：R687[医药卫生—骨科学]