腰椎融合术中应用重组人骨形态发生蛋白2辅助治疗腰椎退行性疾病  

Application of recombinant human bone morphogenetic protein-2 as an adjuvant therapy for lumbar degenerative diseases in lumbar fusion

作　　者：王平[1] 王华勇[2] 王浩[2] 雷大军 Wang Ping;Wang Huayong;Wang Hao;Lei Dajun(Department of Rehabilitation Medicine,Zaoyang First People’s Hospital,Xiangyang 441200,Hubei,China;Department of Orthopaedics,Zaoyang First People’s Hospital,Xiangyang 441200,Hubei,China)

机构地区：[1]枣阳市第一人民医院康复医学科,襄阳441200 [2]枣阳市第一人民医院骨科,襄阳441200

出　　处：《脊柱外科杂志》2023年第6期391-395,共5页Journal of Spinal Surgery

摘　　要：目的评价腰椎融合术中应用重组人骨形态发生蛋白2(rhBMP-2)辅助治疗腰椎退行性疾病(LDD)的可行性及安全性。方法回顾性分析2016年1月—2019年12月采用腰椎融合术治疗的LDD患者136例,其中57例术中采用rhBMP-2辅助治疗(试验组),79例术中未使用rhBMP-2辅助治疗(对照组)。采用疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、并发症发生情况、影像学融合结果评估2组患者临床疗效。并进一步统计并发症发生率与rhBMP-2剂量的相关性。结果所有手术顺利完成,患者随访(4.68±1.70)年。术后1个月、末次随访时2组VAS评分和ODI较术前显著改善,差异均有统计学意义(P<0.05);末次随访时2组ODI较术后1个月进一步改善,对照组VAS评分较术后1个月进一步改善,差异均有统计学意义(P<0.05)。术后1个月2组VAS评分差异有统计学意义(P<0.05),其余各时间点2组VAS评分和ODI差异无统计学意义(P>0.05)。试验组并发症发生率为12.3%,对照组为13.9%,2组并发症发生率差异无统计学意义(P>0.05);rhBMP-2剂量增加与并发症发生率无显著相关性。183个椎间隙术后Lenke分级,试验组优于对照组,差异有统计学意义(P<0.05)。结论腰椎融合术中应用rhBMP-2辅助治疗LDD可改善融合情况,使用时须充分评估适应证、谨慎选择剂量以降低相关并发症的发生风险。Objective To evaluate the feasibility and safety of using recombinant human bone morphogenetic protein-2(rhBMP-2)as an adjuvant therapy for lumbar degenerative disease(LDD)in lumbar fusion surgery.Methods From January 2016 to December 2019,136 patients with LDD were treated with lumbar fusion.Among them,57 patients received rhBMP-2 adjuvant therapy during surgery(experiment group),and 79 did not receive rhBMP-2 adjuvant therapy during surgery(control group).The visual analogue scale(VAS)score,Oswestry disability index(ODI),incidence of complications,and imaging fusion results were used to evaluate the clinical efficacy of the 2 groups.The correlation between complication rate and rhBMP-2 dose was further analyzed.Results All the operations were completed successfully,and the patients were followed up for(4.68±1.70)years.The VAS score and ODI of the 2 groups were improved significantly at postoperative 1 month and at the final follow-up compared to pre-operation,with a statistical significance(P<0.05).The ODI of the 2 groups was further improved at the final follow-up compared to postoperative 1 month,while the VAS score of the control group was further improved at the final follow-up compared to postoperative 1 month,all with a statistical significance(P<0.05).There was a statistically significant difference in VAS score between the 2 groups at postoperative 1 month(P<0.05),while there was no statistically significant difference in VAS score and ODI between the 2 groups at other time points(P>0.05).The incidence of complications was 12.3%in the experiment group and 13.9%in the control group,and there was no significant difference between the 2 groups(P>0.05).There was no significant correlation between the increased dose of rhBMP-2 and the complication rate.The Lenke grading of 183 intervertebral spaces after surgery was better in the experiment group than in the control group,with a statistically significant difference(P<0.05).Conclusion The application of rhBMP-2 as an adjuvant therapy for LDD during lumbar fu

关 键 词：腰椎 椎管狭窄 椎间盘移位 脊椎滑脱 脊柱融合术 骨形态发生蛋白质类 

分 类 号：R681.533[医药卫生—骨科学]