同种异体骨支撑体和钛网修复脊柱结核骨缺损的疗效比较  

Comparison of curative effect of allograft bone brace and titanium mesh in repairing spinal tuberculous bone defect

作　　者：方德健[1] 李思贝 陈豪逸 张强[1] FANG De-jian;LI Si-bei;CHEN Hao-yi(Department of Orthopedics,The Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院外三科,广州510095

出　　处：《中国处方药》2021年第8期1-4,共4页Journal of China Prescription Drug

基　　金：广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]1555号);广东省转化医学创新平台培育建设项目B类(粤卫函[2018]1254号)。

摘　　要：目的比较同种异体骨支撑体与钛网植骨修复脊柱结核骨缺损的疗效。方法回顾性分析2013年1月~2018年1月期间行一期前路病灶清除植骨融合内固定术的脊柱结核患者共68例,采用同种异体骨支撑体植骨及钛网植骨各34例。比较两组患者的手术时间、出血量及血沉(ESR)、C反应蛋白(CRP)的变化,支撑体下沉率,Cobb角的矫正,植骨块融合时间及神经功能恢复情况。结果两组患者的手术时间、出血量、术前ESR、CRP、Cobb角及脊髓功能差异均无统计学意义(P>0.05)。两组术后ESR、CRP、Cobb角及脊髓功能较术前明显改善,但组间差异无统计学意义(P>0.05)。同种异体骨支撑体组植骨块融合时间为4~10个月,平均(5.97±1.70)个月,钛网组植骨块融合时间为6~10个月,平均(7.32±1.12)个月,差异有统计学意义(P<0.05);同种异体骨支撑体组出现支撑体下沉2例,发生率5.9%;钛网组出现支撑体下沉5例,发生率14.7%,差异有统计学意义(P<0.05)。结论同种异体骨支撑体与钛网植骨修复脊柱结核骨缺损均能取得良好的临床疗效,同种异体骨支撑体在融合时间方面优于钛网,钛网较同种异体骨支撑体更容易出现下沉。Objective To compare the efficacy of allogeneic bone support and titanium mesh bone grafting in the repair of tuberculous bone defects in the spine.Methods From January 2013 to January 2018,a total of 68 patients with spinal tuberculosis who underwent one-stage anterior removal,bone grafting,bone fusion and internal fixation in our hospital were retrospectively analyzed.34 patients were treated with allograft support and 34 with titanium mesh respectively.The changes of operation time,blood loss,ESR,C-reactive protein(CRP),subsidence rate of support body,correction of Cobb Angle,graft fusion time and neurological function recovery were compared between the two groups.Results There were no statistically significant differences in operation time,bleeding volume,preoperative ESR,CRP,Cobb Angle or spinal cord function between the two groups.Postoperative ESR,CRP,Cobb Angle and spinal cord function of the two groups were significantly improved compared with those before surgery,but there was no statistically significant difference between the two groups.The graft fusion time in the allogeneic bone support group was 4~10 months,with an average of(5.97±1.70)months;the graft fusion time in the titanium mesh group was 6~10 months,with an average of(7.32±1.12)months,with statistically significant differences.In the allogeneic bone strut group,there were 2 cases of strut sinking,with an incidence of 5.9%.There were 5 cases of support subsidence in the titanium mesh group,with an incidence of 14.7%,and the difference was statistically significant.Conclusion Both allogeneic bone support and titanium mesh grafting can achieve good clinical efficacy in repairing tuberculous bone defects in the spine.Allogeneic bone support is superior to titanium mesh in terms of fusion time,and titanium mesh is more likely to sink than allogeneic bone support.

关 键 词：脊柱结核 同种异体骨 支撑体 钛网 

分 类 号：R687.3[医药卫生—骨科学]