rhBMP-2联合自体骨行椎间植骨融合治疗胸腰椎结核的疗效研究  

Therapeutic effect of rhBMP-2 combined with autologous bone interbody fusion in the treatment of thoracolumbar tuberculosis

作　　者：杜鹏[1] 任磊[1] 赵宇[1] 彭兴国[1] DU Peng;REN Lei;ZHAO Yu;PENG Xing-guo(Department of Spinal Surgery,Affiliated Hospital of Qinghai University,Xining,Qinghai 810000,China)

机构地区：[1]青海大学附属医院脊柱外科,青海西宁810000

出　　处：《颈腰痛杂志》2022年第3期377-380,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨重组人骨形态发生蛋白2(recombinant human bone morphogentic protein-2,rhBMP-2)联合自体骨行椎间植骨融合治疗胸腰椎结核的临床疗效。方法选择2017年1月~2019年1月本院收治的74例胸腰椎结核患者,均采用病灶清除、后路经椎弓根螺钉内固定、植骨融合治疗;根据不同植骨融合方式分组:对照组47例患者仅采用自体骨植骨融合,观察组47例采用rhBMP-2联合自体骨行椎间植骨融合。随访超过1年,比较两组患者的手术指标和手术疗效。结果两组术中出血量、手术时间、住院时间、并发症发生率差异无统计学意义(P>0.05)。两组治疗后ASIA分级均显著改善,但术后6个月、1年的组间差异无统计学意义(P>0.05)。两组治疗后Cobb角、VAS评分以及红细胞沉降率均显著低于术前,且观察组术后6个月VAS评分低于对照组,差异有统计学意义(P<0.05);两组术后1年组间各指标差异均无统计学意义(P>0.05)。观察组术后6个月的植骨融合率显著高于对照组(P<0.05),术后1年时差异无统计学意义(P>0.05)。结论rhBMP-2联合自体骨行椎间植骨融合治疗胸腰椎结核,能够促进植骨融合,具有良好的疗效与安全性。Objective To explore the clinical effect of recombinant human bone morphogenetic protein 2(rhBMP-2)combined with autologous bone interval graft fusion in the treatment of thoracolumbar spine tuberculosis.Methods Seventy-four patients with thoracolumbar tuberculosis from January 2017 to January 2019 were selected as the study subjects.All patients were treated with lesion removal,posterior pedicle screw internal fixation,and bone graft fusion treatment.According to different bone graft fusion methods,the patients were divided into two groups.The control group(47 cases)only used autologous bone graft fusion,and the observation group(47 cases)received rhBMP-2 combined with autologous intervertebral bone graft fusion.The patients were followed up for more than 1 year.The surgical indicators and curative effects of the two groups were compared.Results There were no significant differences in the amount of intraoperative blood loss,operation time,hospitalization time,and incidence rate of complications between the two groups(P>0.05).The ASIA classification of the two groups was significantly improved after treatment,but there was no statistically significant difference between the two groups at 6 months and 1 year after operation(P>0.05).After treatment,the Cobb angle,VAS score,and ESR of the two groups were significantly lower than before operation.At 6 months after operation,the VAS score of the observation group was lower than that of the control group(P<0.05).There were no statistically significant differences in the indicators between the two groups at 1 year after operation(P>0.05).The fusion rate of bone grafting in the observation group at 6 months after operation was significantly higher than that in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups at 1 year after operation(P>0.05).Conclusion rhBMP-2 combined with autogenous bone interbody fusion in the treatment of thoracolumbar vertebral tuberculosis can promote bo

关 键 词：重组人骨形态发生蛋白 自体骨 椎间植骨融合 胸腰椎结核 

分 类 号：R529.2[医药卫生—内科学]