中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (43): 6389-6395.doi: 10.3969/j.issn.2095-4344.2016.43.001

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials •    下一篇

生物骨材料混合自体髂骨修复寰枢椎可复性脱位:后路固定植骨融合

罗  旭1,李  丹1,梁英杰2 
  

  1. 1武警湖南总队医院,湖南省长沙市  410000;2广州医学院附属第一人民医院脊柱外科(广州市第一人民医院),广东省广州市  510180
  • 收稿日期:2016-08-09 出版日期:2016-10-21 发布日期:2016-10-21
  • 通讯作者: 罗旭,武警湖南总队医院,湖南省长沙市 410000
  • 作者简介:罗旭,男,1968年生,湖南省永顺市人,硕士,副主任医师,主要从事骨外科临床医学研究。
  • 基金资助:

    广东省科技计划项目(2014A020212571)

Biological bone mixed with autologous bone for reducible atlantoaxial dislocation via posterior reduction with bone graft fusion

Luo Xu1, Li Dan1, Liang Ying-jie2
  

  1. 1Hunan Armed Police Corps Hospital, Changsha 410000, Hunan Province, China; 2Department of Spinal Surgery, First People’s Hospital of Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China
  • Received:2016-08-09 Online:2016-10-21 Published:2016-10-21
  • Contact: Luo Xu, Hunan Armed Police Corps Hospital, Changsha 410000, Hunan Province, China
  • About author:Luo Xu, Master, Associate chief physician, Hunan Armed Police Corps Hospital, Changsha 410000, Hunan Province, China
  • Supported by:

    the Scientific Research Plan of Guangdong Province, No. 2014A020212571

摘要:

文章快速阅读:

 

文题释义:
生物骨材料
:是一类可对机体组织进行修复、替代、再生,具有特殊功能的材料,其具有可降解性,植入体内后,在局部骨组织的微环境下被再生的骨组织所替代。
生物骨材料的特性:生物安全性良好,对人体无害无毒或低毒无损害;抗压强度、抗拉伸及抗折强度较高,可起到一定的支撑作用;生物骨材料具有一定的微孔结构,为骨细胞提供三维生长空间和组织微环境,利于新骨细胞的长入、黏附、生长;具有可降解性,随着机体骨髓腔结构变化逐步降解被周围骨质所替代;具有一定的引导或诱导成骨活性。

背景:研究表明,腰椎融合中生物骨材料植骨与自体髂骨移植相当,却明显降低了二次手术的风险,同时能更好地改善椎体功能障碍指数。
目的:评价生物骨材料混合自体髂骨在寰枢椎可复性脱位后路钉棒内固定植骨融合中的效果。
方法:选择可复性寰枢椎脱位患者72例,其中男37例,女35例,年龄28-72岁,均施行寰枢椎后路钉棒内固定植骨融合,寰椎采用侧块螺钉或椎弓根螺钉固定,枢椎采用椎弓根螺钉、椎板螺钉或侧块螺钉固定,分2组进行植骨融合:试验组(n=34)采用生物骨材料混合自体髂骨颗粒植骨融合,对照组(n=38)采用自体髂骨移植融合。治疗后随访12个月,对比两组植骨融合率、疼痛缓解、颈椎功能恢复、颈椎活动度及并发症发生情况。
结果与结论:随访12个月,所有患者寰枢椎脱位复位内固定满意,颈部切口均I/甲愈合,均获得良好的骨性融合,融合率达100%;两组疼痛、颈椎功能、颈椎曲度和活动度均较治疗前明显改善(P < 0.05),两组间植骨融合率、颈椎功能、颈椎曲度和活动度比较差异均无显著性意义;试验组取骨量、疼痛缓解时间少于对照组(P < 0.05)。结果表明,采用生物骨材料混合自体髂骨进行可复性寰枢椎脱位后路钉棒内固定并植骨融合,可迅速缓解疼痛,减少取骨量,植骨融合率良好,颈椎功能恢复良好。

关键词: 生物材料, 骨生物材料, 自体髂骨, 寰枢关节, 脱位, 后路手术, 融合

Abstract:

BACKGROUND: Studies have shown that biological bone and autogenous iliac bone exhibit equivalent lumbar fusion effects, but the former one significantly reduces the risk of secondary surgery and contributes to improving vertebral dysfunction.
OBJECTIVE: To evaluate the effect of biological bone mixed with autologous bone in posterior screw rod internal fixation with bone graft fusion for reducible atlantoaxial dislocation.
METHODS: Seventy-two patients with recoverable atlantoaxial dislocation, including 37 males and 35 females, aged 28-72 years old, were all subjected to posterior atlantoaxial screw rod fixation with bone graft fusion: the atlas was fixed with lateral mass screw or pedicle screw, and the axis fixed with the pedicle screw, lamina screws or lateral mass screw. These patients were assigned into experimental group (n=34) undergoing biological bone mixed with autologous iliac particle bone graft fusion, or control group (n=38) undergoing autologous iliac bone graft fusion. Twelve months later, fusion rate, pain relief, cervical function recovery, cervical activity and complications were compared between the two groups.
RESULTS AND CONCLUSION: After postoperatively 12 months, all patients were satisfied with atlantoaxial dislocation reduction, with a good bone fusion rate up to 100%, and their neck incision healed well by primary intention. The pain, cervical function, cervical curvature and activity were improved significantly in the two groups after treatment (P < 0.05), but there was no significant difference between the two groups. Compared with the control group, the amount of bone mass taken from the patient and pain relief time were lower in the experimental group (P < 0.05). Taken together, the biological bone mixed with autogenous iliac bone for reducible atlantoaxial dislocation via posterior screw rod internal fixation and bone graft fusion can rapidly relieve pain, reduce the amount of bone mass taken from patients, and achieve good fusion effect and cervical functional recovery.

Key words: Atlanto-Axial Joint, Internal Fixators, Spinal Fusion, Tissue Engineering

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