摘要
目的 探讨颈椎前路椎间盘摘除植骨融合术（anterior cervical discectomy and fusion,ACDF）中应用新型脱细胞同种异体骨的临床效果。方法 回顾性分析2009年1月-2013年12月收治的73例行ACDF的单节段颈椎病患者临床资料。根据术中所用植骨材料将患者分为3组,其中A组22例取自体髂骨移植,B组27例使用新型脱细胞同种异体骨——拜欧金移植,C组24例使用普通同种异体骨——鑫康晨移植。3组患者性别、年龄、颈椎病分型、病程、病变节段等一般资料比较差异无统计学意义（P〉0.05）,有可比性。比较3组患者手术时间、术中出血量、并发症发生情况;摄X线片及CT扫描观察植骨融合情况;采用日本骨科协会（JOA）评分评价患者疼痛缓解情况并计算改善率。结果 A组手术时间及术中出血量显著多于B、C组（P〈0.05）,B、C组间差异无统计学意义（P〉0.05）。A组出现供骨区疼痛、麻木12例,伤口愈合不良1例;B、C组术后分别出现伤口红肿渗液1例和6例;3组并发症发生率比较差异有统计学意义（χ2=18.82,P=0.00）。所有患者均获随访,随访时间6～54个月,平均30个月。术后6个月A、B组患者均达骨性融合（100%）,C组23例达骨性融合（95.8%）,3组融合率比较差异无统计学意义（χ2=2.04,P=0.36）。术后6个月3组患者JOA评分均较术前显著改善（P〈0.05）;但术前及术后6个月3组间比较JOA评分,差异均无统计学意义（P〉0.05）。A、B、C组JOA评分优良率分别为90.9%、88.9%、87.5%,3组比较差异无统计学意义（χ2=0.14,P=0.93）。结论 新型脱细胞同种异体骨用于ACDF具有手术时间短、出血少、早期临床效果满意等优点,但仍需进一步研究其是否存在慢性排斥反应和延迟排斥反应。
Objective To analyze the effectiveness of a new type of decellularized allogeneic bone in the application of anterior cervical discectomy and fusion （ACDF）. Methods A retrospective analysis was made on the clinical data of 73 patients with single segmental cervical spondylosis treated with ACDF between January 2009 and December 2013. Of 73 cases, autologous iliac bone was used in 22 cases （group A）, new decellularized allogeneic bone transplantation （Bio-Gene） in 22 cases （group B）, and normal allogeneic bone （Xin Kang Chen） in 24 cases （group C）. There was no significant difference in gender, age, type of cervical spondylosis, course of disease, and involved segment among 3 groups （P〉O.05）. The operation time, intraoperative blood loss, and complications were compared between groups; X-ray films and CT images were taken to observe the bone fusion, and Japanese Orthopaedic Association （JOA） score was used to assess the clinical efficacy. Results The operation time and intraoperative blood loss of group A were significantly more than those of groups B and C （P〈0.05）, but no significant difference was found between groups B and C （P〉0.05）. Pain and numbness at donor site occurred in 12 cases, and poor healing in i case of group A; red swelling and exudate were observed in 1 case of group B and in 6 cases of group C; and there was significant difference in complications among 3 groups （X2=18.82, P=0.00）. All patients were followed up 6-54 months （mean, 30 months）. The graft fusion rate was 100% in groups A and B, and was 95.8% in group C, showing no significant difference （X2=2.04,P=0.36）. The JOA score at 6 months after operation were significantly improved when compared with preoperative score in 3 groups （P〈0.05）, but no significant difference was found among the 3 groups at preoperation and 6 months after operation （P〉0.05）. The excellent and good rates of groups A, B, and C were 90.9%, 88.9%, and 87.5% respectively, showing no significant d
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2015年第5期567-571,共5页
Chinese Journal of Reparative and Reconstructive Surgery
