中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (44): 8261-8264.doi: 10.3969/j.issn.2095-4344.2012.44.018

• 骨科植入物 orthopedic implant • 上一篇    下一篇

自体骨、同种异体骨及骨形态发生蛋白重组骨治疗腰椎骨折

山富彦   

  1. 河南省南阳医学高等专科学校附属第一医院骨科,河南省南阳市 473000
  • 收稿日期:2012-03-12 修回日期:2012-07-04 出版日期:2012-10-28 发布日期:2012-10-28
  • 作者简介:山富彦,男,1963年生,河南南阳市人,汉族,1985年河南医科大学毕业,主治医师,主要从事脊柱外科及创伤骨科的研究。 174248262@qq.com

Autogenous bone, allogeneic bone and bone morphogenic protein micromorselized bone for the treatment of lumbar fracture

Shan Fu-yan   

  1. Department of Orthopedics, the First Affiliated Hospital of Nanyang Medical College, Nanyang 473000, Henan Province, China
  • Received:2012-03-12 Revised:2012-07-04 Online:2012-10-28 Published:2012-10-28
  • About author:Shan Fu-yan, Attending physician, Department of Orthopedics, the First Affiliated Hospital of Nanyang Medical College, Nanyang 473000, Henan Province, China 1742482622@qq.com

摘要:

背景:骨形态发生蛋白重组骨是一种新型植骨材料,已逐步应用于临床,但在腰椎骨折植骨融合中效果仍少见报道。
目的:比较自体骨、同种异体骨及骨形态发生蛋白重组骨治疗腰椎骨折的疗效差异。
方法:选择2005年3月至2009年3月南阳医学高等专科学校附属第一医院收治的腰椎骨折患者78例,根据植骨材料不同随机分为3组,分别植入自体骨、同种异体骨、骨形态发生蛋白重组骨。
结果与结论:78例腰椎骨折患者均获24个月的随访。植骨后24个月JOA评分改善率骨形态发生蛋白植入组90%>自体骨植入组85%>同种异体骨植入组70%(P < 0.05);植骨后12,24个月,同种异体骨植入组Cobb角较其他2组和植骨后6个月增大(P < 0.05),较植骨前减小(P < 0.05);自体骨植入组与骨形态发生蛋白植入组相比,差异无统计学意义(P > 0.05);同种异体骨植入组植骨后各时间点骨融合率均低于其他2组(P < 0.05)。提示骨形态发生蛋白重组骨与自体骨应用于脊椎腰椎骨折近期疗效相似,均优于同种异体骨移植,骨形态发生蛋白重组骨在腰椎骨折脊柱融合快,效果更好,临床应用更有优势。

关键词: 自体骨, 同种异体骨, 腰椎骨折, 植骨融合, 骨形态发生蛋白, JOA评分, Cobb角, 人工骨, 骨移植

Abstract:

BACKGROUND: Bone morphogenic protein micromorselized bone is a new type of bone graft materials which has been gradually applied in clinic, but the reports about the effect of bone graft fusion on the lumbar fracture are rare.
OBJECTIVE: To compare the clinical effect of autogenous bone, allogeneic bone and bone morphogenic protein micromorselized bone for the treatment of lumbar fracture.
METHODS: This study retrospectively collected 78 patients with lumbar spinal fracture in First Affiliated Hospital of Nanyang Medical College from March 2005 to March 2009, and the 78 patients were randomly divided into three groups, and the autogenous bone, allogeneic bone and bone morphogenic protein micromorselized bone were implanted respectively.
RESULTS AND CONCLUSION: All the 78 patients were followed-up for 24 months. There was a significant difference of Japanese Orthopaedic Association score at 24 months after grafting, the Japanese Orthopaedic Association score in bone morphogenic protein group was 90% > autogenous bone group 85% > allogeneic bone group 70% (P < 0.05); at 12 and 24 months after grafting, the Cobb angle in the allogeneic bone group was larger than that in the other two groups at 12 and 24 months after grafting, and also larger than that in the allogeneic bone group at 6 months after grafting (P < 0.05), but smaller than that before grafting (P < 0.05), and there was significant difference between autogenous bone group and bone morphogenic protein group (P > 0.05); the bone fusion rate at different time points in the autogenous bone group was lower than that in the other two groups (P < 0.05). Bone morphogenic protein micromorselized bone is equivalent to autogenous bone graft in treating lumbar fracture, both are superior to allogeneic bone transplantation, and bone morphogenic protein micromorselized bone can facilitate the bone fusion with good effect and to be recommended in the clinical application.

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