中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (43): 6983-6987.doi: 10.3969/j.issn.2095-4344.2015.43.018

• 纳米生物材料 nanobiomaterials • 上一篇    下一篇

腰椎后外侧纳米晶胶原基骨材料植骨融合：疼痛评分及植骨融合效果的评价

李 黛1，杨明敏2，孙 扬3   

  1. 1解放军第二军医大学附属长海医院麻醉疼痛中心，上海市  200433；2新疆医科大学第一附属医院骨科中心，新疆维吾尔自治区乌鲁木齐市  830011；3新疆医科大学第一附属医院，新疆维吾尔自治区乌鲁木齐市  830011
  • 收稿日期:2015-07-23 出版日期:2015-10-15 发布日期:2015-10-15
  • 通讯作者: 孙扬，主治医师，新疆医科大学第一附属医院，新疆维吾尔自治区乌鲁木齐市 830011
  • 作者简介:李黛，女，1987年生，河北省枣强县人，汉族，2015年中山大学毕业，博士，医师，主要从事病理性疼痛的机制及治疗研究。 并列第一作者：杨明敏，男，1984年生，江苏省启东市人，回族，2015年新疆医科大学毕业，硕士，医师，主要从事骨科术后慢性痛与康复方面的研究。

Application of nanohydroxyapatite/collagen basal bone materials in lumbar posterolateral bone graft fusion: evaluation of pain scores and bone graft fusion effects

Li Dai1, Yang Ming-min2, Sun Yang3   

  1. 1Anesthesia Pain Center, Changhai Hospital, Second Military Medical University of Chinese PLA, Shanghai 200433, China; 2Orthopedic Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China; 3the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
  • Received:2015-07-23 Online:2015-10-15 Published:2015-10-15
  • Contact: Sun Yang, Attending physician, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
  • About author:Li Dai, M.D., Physician, Anesthesia Pain Center, Changhai Hospital, Second Military Medical University of Chinese PLA, Shanghai 200433, China Yang Ming-min, Master, Physician, Orthopedic Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China Li Dai and Yang Ming-min contributed equally to this work.

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摘要：

背景：纳米晶胶原基骨材料具有与天然骨十分接近的多孔结构，植入人体后，可随着时间的推移逐渐发生降解和吸收，发挥强大的引导和桥梁作用。
目的：观察腰椎后外侧植骨融合中应用纳米晶胶原基骨材料的临床效果。
方法：纳入58例腰椎疾病患者，其中男28例，女30例，年龄47-81岁，经后正中入路实施腰椎椎板切除减压，或者同时实施髓核摘除、腰椎后外侧横突间植骨融合，植骨材料为纳米晶胶原基骨修复材料，利用椎弓根螺钉系统进行内固定。治疗后随访18个月，观察疼痛缓解及植骨融合情况。
结果与结论：58例患者均顺利完成治疗过程，切口均Ⅰ期愈合，临床症状和体征较治疗前明显改善，经随访未出现感染、螺钉移位与松动、固定节段相临椎体滑脱与移位等并发症，未发生与植骨材料相关的不良反应。纳米晶胶原基骨材料植入后1，6，12，18个月的下肢和下腰目测类比评分均低于植入前(P < 0.05)。随访12个月植骨融合率为84%，18个月时植骨融合率为90%。表明腰椎后外侧植骨融合过程中应用纳米晶胶原基骨材料可缓解下肢痛及下腰痛症状，利于植骨融合。
中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

关键词: 生物材料, 骨生物材料, 纳米晶胶原基骨材料, 腰椎, 后外侧植骨融合, 疼痛, 组织构建

Abstract:

BACKGROUND: Nanohydroxyapatite/collagen basal bone materials have a porous structure which is very close to natural bone. After implanting to the human body, it can be gradually degraded and absorbed over time to play a strongly guiding and bridging role.

OBJECTIVE: To investigate the clinical effect of nanohydroxyapatite/collagen basal bone materials on lumbar posterolateral bone graft fusion.
METHODS: Fifty-eight patients with lumbar disease, including 28 males and 30 females, aged 47 to 81 years were included and were performed lumbar laminectomy via posterior midline approach, or simultaneously performed discectomy and lumbar posterolateral bone graft fusion between transverse process. The bone graft material was nanohydroxyapatite/collagen basal bone repair material. Pedicle screw system was used to make the internal fixation. Patients were followed up for 18 months after treatment. Pain relief and bone graft fusion condition were observed.
RESULTS AND CONCLUSION: Fifty-eight patients had successfully completed the treatment. The incisions healed by first intention. The clinical symptoms and signs were significantly improved compared with before treatment. The complications such as infection, screws shifting and loosening, spondylolisthesis and displacement of adjacent vertebral in fixed segments, and the adverse reactions associated with bone graft material were not occurred during the follow-up. At the 1st, 6th, 12th and 18th months after implanting nanohydroxyapatite/collagen basal bone materials, the visual analog scale scores of the lower limbs and waist were all lower than those before implantation (P < 0.05). At the 12th and 18th months of follow-up, the bone graft rates were 84% and 90%, respectively. These results demonstrate that the application of nanohydroxyapatite/collagen basal bone materials in the process of lumbar posterolateral bone graft fusion can ease the symptoms of lower limb pain and lower back pain, which is conducive to bone graft fusion. 
中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Lumbar Vertebrae, Spinal Fusion, Pain Measurement, Tissue Engineering