同种异体辐照冻干小骨块与自体小骨块混合移植在脊柱融合术中的应用观察  

Application of Mixed Transplantation of Allogeneic Bone Processed by Lyophilization and Radiation and Autogenous Bone in Spinal Fusion

作　　者：赵兵[1] 黄海锋[1] 尹振宇[1] 羊刚毅[1] 崔易坤[1] 宋晋刚[1] ZHAO Bing;HUANG Hai-feng;YIN Zhen-yu;YANG Gang-yi;CUI Yi-kun;SONG Jin-gang(Department of Spine Surgery,Central Hospital of Mianyang,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市中心医院脊柱外科,四川绵阳621000

出　　处：《临床误诊误治》2020年第12期56-60,共5页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫计委普及应用项目(16pj191)。

摘　　要：目的探讨同种异体辐照冻干小骨块与自体小骨块混合移植在脊柱融合术中的应用效果。方法选取2017年7月—2019年2月在我院行脊柱融合术治疗患者68例,据植骨材料的不同分为研究组和对照组各34例,对照组采用自体小骨块行脊柱融合术治疗,研究组采用同种异体辐照冻干小骨块与自体小骨块混合移植行脊柱融合术治疗。比较两组脊柱融合时间及融合失败率,术前及术后1周、1年日本骨科协会(Japanese orthopaedic association,JOA)评分及椎间隙高度,术后并发症发生情况和术后3个月治疗满意度。结果两组脊柱融合时间及融合失败率比较差异均无统计学意义(P>0.05)。两组术后1周、1年JOA评分均显著高于术前(P<0.01),术后1周JOA评分低于术后1年(P<0.05),但两组术后1周、1年JOA评分比较差异无统计学意义(P>0.05)。术后3个月、1年两组椎间隙高度均显著高于术前(P<0.01),但两组术前及术后3个月、1年组间和两组术后3个月、1年组内椎间隙高度比较差异均无统计学意义(P>0.05)。两组术后并发症发生率及治疗满意度比较差异无统计学意义(P>0.05)。结论同种异体辐照冻干小骨块与自体小骨块混合移植在脊柱融合术中的治疗效果与单纯自体小骨块移植相当,且不会增加术后并发症,患者预后较佳,可弥补自体骨量不足的缺点。Objective To explore the application effect of mixed transplantation of allogeneic bone processed by lyophilization and radiation and autogenous bone in spinal fusion.Methods Sixty-eight patients who underwent spinal fusion in our hospital between July 2017 and February 2019 were selected as the study subjects.According to the difference bone graft materials,they were divided into research group and control group,with 34 cases in each group.The control group was treated with spinal fusion with autogenous bone and the research group was treated with spinal fusion with mixed transplantation of allogeneic bone processed by lyophilization and radiation and autogenous bone.The spinal fusion time and fusion failure rate,the Japanese Orthopaedic Association(JOA)score and intervertebral space height before operation and at 1 week and 1 year after the operation,the incidence of postoperative complications and the satisfaction with treatment at 3 months after surgery between the two groups were compared.Results There was no significant difference in spinal fusion time and failure rate between the two groups(P>0.05).The JOA scores of the two groups at 1 week and 1 year after surgery were significantly higher than those before surgery(P<0.01),and the JOA score at 1 week after surgery was lower than that at 1 year after surgery(P<0.05).There was no significant difference in JOA scores between the two groups at 1 week and 1 year after operation(P>0.05).The height of intervertebral space at 3 months and 1 year after surgery was significantly higher than that before surgery(P<0.01),but there was no significant intragroup or intergroup difference before the operation,at 3 months and 1 year after operation(P>0.05).No statistically significant difference was found in the incidence of postoperative adverse reactions and satisfaction with treatment between the two groups(P>0.05).Conclusion The therapeutic effect of mixed transplantation of allogeneic bone processed by lyophilization and radiation and autogenous bone in spinal fusion

关 键 词：脊柱融合术 同种异体辐照冻干小骨块 自体小骨块 混合移植 椎间隙高度 手术后并发症 

分 类 号：R681.5[医药卫生—骨科学]