摘要
背景:颈椎前路椎间盘切除减压自体髂骨植骨融合是治疗颈椎病的标准术式,但取自体髂骨存在较多供骨区并发症,寻找合适的骨修复替代材料应用于颈椎前路手术一直是研究的热点。目的:分析含骨形态发生蛋白2骨修复材料在颈椎前路减压融合中的临床效果。方法:回顾性分析行颈前路减压植骨融合治疗40例患者的临床资料,其中试验组21例将含骨形态发生蛋白2的骨修复材料(载体为药用明胶、注射用大豆卵磷脂、羟基磷灰石等)及自体骨赘植入PEEK cage融合器,对照组19例将自体骼骨植入PEEK cage融合器。随访12个月,比较两组融合节段Cobb角、融合节段椎体前缘高度、椎间高度、并发症、融合率、JOA评分和目测类比评分等指标。结果与结论:经过治疗后,两组均获得了即刻的颈椎稳定,颈椎前凸、融合节段椎体前缘高度及椎间高度均较治疗前明显增加(P<0.05)。随访12个月时,试验组Cobb角明显大于对照组(P<0.05),两组融合节段椎间隙前缘高度与融合节段椎间高度、椎间融合率、颈部与上肢目测类比评分、JOA评分比较差异无显著性意义,均获得骨性愈合。表明含骨形态发生蛋白2的骨修复材料结合自体骨赘植骨应用于颈椎前路减压融合可有效恢复并维持颈椎前凸、融合节段的高度,在改善临床症状方面与自体髂骨疗效相当。
The anterior cervical discectomy and fusion with autologous bone is the standard surgical treatment for cervical spondylosis, but there are more complications occurring during the harvesting of autologous iliac bone. To find suitable alternative materials used in bone repair surgery has been a research focus.
OBJECTIVE：To analyze the clinical and radiographic outcomes in patients undergoing anterior cervical discectomy with fusion using polyetheretherketone cages packed with bone repair material containing recombinant human bone morphogenetic protein-2.
METHODS：A total of 40 consecutive patients with cervical spinal degenerative disease who underwent anterior cervical discectomy and fusion were enrol ed. We retrospectively reviewed anterior cervical discectomy with fusion using polyetheretherketone cages packed with bone repair material containing recombinant human bone morphogenetic protein-2 and autologous osteophyte in 21 cases and with autologous iliac crest in 19 cases. These patients had sequential radiographs before and after surgery, and at 1 year. The anterior disc height, interbody height, segmental Cobb angle, complication, and fusion rate were assessed based on radiographs including flexion/extension radiographs and CT scan. The neurologic outcomes were evaluated using the visual＆amp;nbsp;analog scale score for neck and arm pain and the Japanese Orthopedic Association scoring system for myelopathy.
RESULTS AND CONCLUSION：At the last fol ow-up, solid fusion appeared to have been achieved in patients of both groups. Lordosis was increased significantly in both groups after surgery （P〈0.05）, and was maintained up until 1 year without a difference between groups. Both the anterior disc height and interbody height were significantly increased after surgery （P〈0.05）, without a significant difference between groups. At the last fol ow-up, the Cobb angle in the test group was significantly higher than that in the control group （P〈0.05）, but there was no significant difference i
出处
《中国组织工程研究》
CAS
CSCD
2014年第43期6889-6895,共7页
Chinese Journal of Tissue Engineering Research
关键词
骨形态发生蛋白质类
颈椎
脊柱融合术
bone morphogenetic proteins
cervical vertebrae
spinal fusion
