摘要
目的评价BMP-2混合自体髂骨植骨在可复性寰枢椎脱位后路复位固定植骨融合术中的融合效果的。方法回顾性分析自2004-01—2012-01采用BMP-2与自体髂骨混合植骨进行寰枢椎后路复位固定融合术治疗的41例可复性寰枢椎脱位（BMP-2组）,并与同期仅采用自体髂骨植骨治疗的65例（自体髂骨组）进行比较。比较2组手术时间、术中出血量、术后引流量、自体髂骨取骨量、并发症发生率,以及术后12个月时VAS评分、JOA评分、颈椎曲度、颈椎活动度。结果 106例获得平均（25.8±1.6）个月随访,术后12个月影像学检查显示均获得满意复位及骨性融合,融合率达100%。2组手术时间、术中出血量、术后引流量,以及术后12个月的VAS评分、JOA评分、颈椎曲度、颈椎活动度比较差异无统计学意义（P〉0.05）;但BMP-2组自体髂骨取骨量明显少于自体髂骨组,差异有统计学意义（P〈0.05）。2组并发症发生率差异无统计学意义（χ^2=1.459,P=0.083）。结论采用BMP-2混合自体髂骨进行可复性寰枢椎脱位后路钉棒内固定植骨融合术可以减少自体髂骨的切取量,缩短术后疼痛缓解时间,而且并未增加术后并发症的发生率。
Objective To evaluate fusion effect of BMP-2 mixed with autologous bone in aflantoaxial dislocation with posterior screw rod internal fixation and bone grafting fusion surgery. Methods The posterior atlantoaxial reduction and fixation and bone grafting fusion using BMP-2 mixed with autogenous iliac bone grafting for 41 cases of atlantoaxial dislocation （group BMP-2） and only autologous iliac bone grafting for 65 cases （group autograft） from January 2004 to January 2012 were retrospectively analyzed and compared. The operative time, bleeding volume, postoperative drainage volume, autologous iliac crest bone, the incidence of complications, and VAS score, JOA score, cervical lordosis, cervical activity 12 months after operation were compared between these two groups. Results One hundred and six cases were followed up with an average （25.8＋l.6）months, and the imaging examination showed satisfactory reduction and bony fusion, the fusion rate was 100% at 12 months after the operation. There were no significant differences between two groups in operative time, bleeding volume, postoperative drainage volume, the incidence of complications, and VAS score, JOA score, cervical lordosis, cervical activity 12 months after operation（P 〉0.05）. But the autogenous iliac bone graft mass of the group BMP-2 was less than that of group autograft（P 〈0.05）. There was no significant difference in the incidence of complications between two groups（x2 =1.459, P =0.083）. Conclusion The posterior screw rod fixation and bone grafting fusion surgery using BMP-2 mixed with autologous bone for atlantoaxial dislocation can decrease the mass of iliac bone graft and shorten the postoperative pain time without increase of the occurrence rate of the postoperative complications.
作者
何保华
朱伟
夏虹
郑小飞
HE Bao-hua ZHU Wei XIA Hong ZHENG Xiao-fei(Department of Orthopedics, China Meitan General Hospital, Beo＇ing 100028, China)
出处
《中国骨与关节损伤杂志》
2016年第9期897-900,共4页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金(81172012)
关键词
寰枢椎脱位
后路复位固定植骨融合术
BMP-2
自体髂骨
组织工程
Atlantoaxial dislocation
Posterior fixation and interbody fusion
Bone morphogenetic protein-2
Autogenous iliac bone
Tissue engineering
