中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (4): 718-721.doi: 10.3969/j.issn.1673-8225.2010.04.035

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

自体骨或硫酸钙人工骨结合MC+®椎间融合器在颈椎前路融合中的应用：疗效及并发症比较

陈同磊1，成茂华1，沈忆新1，言湛军1，连晓宁2，董启榕1   

  1. 1苏州大学附属第二医院骨科，江苏省苏州市 215004; 2苏州大学基础医学与生物科学学院细胞分子生物学教研室，江苏省苏州市  215123
  • 出版日期:2010-01-22 发布日期:2010-01-22
  • 通讯作者: 董启榕，博士，教授，博士生导师，苏州大学附属第二医院骨科，江苏省苏州市 215004 dqr@szgk.net
  • 作者简介:陈同磊★，男，1981年生，河北省邢台市人，苏州大学在读硕士，主要从事骨科学方面的研究。 tonglei01@tom.com

Application of MC+® combined with autogenous bone or calcium sulfate artificial bone in anterior cervical fusion: Comparative study of therapeutic effects and complications

Chen Tong-lei1, Cheng Mao-hua1, Shen Yi-xin1, Yan Zhan-jun1, Lian Xiao-ning2, Dong Qi-rong1   

  1. 1 Department of Orthopaedics, Second Affiliated Hospital of Soochow University, Suzhou   215004, Jiangsu Province, China; 2 Cell and Molecular Biology Institute, College of Basic Medicine and Biological Science, Soochow University, Suzhou   215123, Jiangsu Province, China
  • Online:2010-01-22 Published:2010-01-22
  • Contact: Dong Qi-rong, Doctor, Professor, Doctoral supervisor, Department of Orthopaedics, Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China dqr@szgk.net
  • About author:Chen Tong-lei★, Studying for master’s degree, Department of Orthopaedics, Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China tonglei01@tom.com

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摘要：

背景：自体骨在颈椎植骨融合术中应用最早、最多，但其来源有限，同时也带来供骨区感染、出血、术后疼痛等并发症。近年来随着新型植骨融合材料的使用，使上述并发症得以避免或减少。
目的：比较MC+®椎间融合器结合自体骨与硫酸钙人工骨在颈椎前路融合中的临床效果。
方法：于2008-01/12对26例脊髓型颈椎病患者共34个节段实施前路椎间盘摘除、椎体融合术，取颈前斜切口3.0~4.0 cm，切除椎间盘及后纵韧带，保留终板，自体骨组椎间融合器填充自体髂骨松质骨，硫酸钙组椎间融合器填充Wright公司OsteoSet人工骨，结合固定嵌片使用。以术后X射线片和JOA评分及术后Odom’s疗效评定标准评价疗效。
结果与结论：两组共26例患者(34个节段)全部获得随访，术后两组JOA评分无明显差异，术后两组临床疗效评定(Odom’s标准)优良率，硫酸钙组高于自体骨组，但差异无显著性意义(P > 0.05)。术后3，6个月人工骨组融合率比自体骨组低，但12个月时两组融合率均为100%。硫酸钙组术后6个月前凸角丢失较自体骨组多0.4°，两组间比较差异无显著性意义(P > 0.05)。提示硫酸钙结合MC+®椎间融合器与自体骨结合MC+®椎间融合器治疗脊髓型颈椎病的临床疗效一致，但硫酸钙人工骨可以有效避免取骨区并发症。

关键词: 脊髓型颈椎病, 聚醚醚酮, 硫酸钙人工骨, 生物材料, 硬组织植入物

Abstract:

BACKGROUND: Autogenous bone has been used in cervical vertebra graft bone fusion in earliest stage and at most. However, its source is limited, simultaneously, induced many complications such as infection, hemorrhage and postoperative pain in the donor bone region. Recently, above-mentioned complications were avoided or reduced with the usage of new graft bone fusion material.
OBJECTIVE: To compare clinical efficacy using MC+® combination of autogenous bone or calcium sulfate artificial bone in anterior cervical fusion.
METHODS: A total of 26 patients (34 levels) with cervical spondylotic myelopathy underwent anterior cervical discectomy and cervical intervertebral fusion from January to December 2008. Anterior cervical oblique cut was 3.0-4.0 cm. The endplate were preserved after the cervical intervertebral disc and the posterior longitudinal ligament were removed. Autogenous bone group was filled with autogenous bone. Calcium sulfate artificial bone group was filled with Wright's Osteoset artificial bone. Anchoring clip was implanted between the cervical vertebrae. Every patient had a short neck incision was assessed with X-ray, JOA grade and Odom’s evaluation scale.
RESULTS AND CONCLUSION: The two groups of 26 patients (34 segments) were followed up. The JOA score of postoperation was no significant difference between the two groups. According to the Odom’s evaluation scale, the excellent and good rate of calcium sulfate group was higher than autogenous bone group, but there was not statistical significance (P > 0.05). The fusion rate of autogenous bone group was higher than calcium sulfate group at 3 and 6 months, but the fusion rate of two groups were 100% at 12 months. Although the calcium sulfate group at 6 months, lordosis angle lost more than 0.4 ° than the autogenous bone group, but no significant statistically between the two groups (P > 0.05). MC+® combination of autogenous bone or calcium sulfate had the same clinical efficacy in the treatment of cervical spondylotic myelopathy, but the calcium sulfate artificial bone could be effectively avoided the complications of donor site.

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