同种异体骨与自体骨植骨治疗胸腰段结核的研究Efficacy of allogenic bone grafting or autogenous bone grafting with posterior debridement instrumentation in the treatment of thoracolumbar tuberculosis
王锡阳;罗承科;邓强;葛磊;段春岳;周炳炎;庞晓阳;曾浩;许正权;
摘要(Abstract):
[目的]探讨同种异体骨和自体骨植骨术在治疗胸腰段结核中的疗效。[方法]回顾分析77例胸腰段结核患者,同种异体骨植骨(A组)40例;自体肋骨植骨(B组)37例。比较两组的手术时间、术中出血量、住院天数和手术前后的ASIA分级、植骨融合率、Cobb角。[结果]随访7~34个月,平均18.6个月。A、B组手术时间、术中出血量、住院天数比较有明显差异(P<0.05)。两组内比较手术前后的ASIA分级、Cobb角有明显差异(P<0.05);两组间比较ASIA分级、Cobb角,植骨融合率无明显差异(P>0.05)。[结论]A、B组术后2.5年复查X线片,按照Zenya Ito标准,植骨融合率没有差异,但A组手术时间短、出血少、住院时间短。
关键词(KeyWords): 胸腰椎结核;同种异体骨移植;自体骨移植;骨移植
基金项目(Foundation): 国家自然科学基金项目(编号:81171736)
作者(Author): 王锡阳;罗承科;邓强;葛磊;段春岳;周炳炎;庞晓阳;曾浩;许正权;
Email:
DOI:
参考文献(References):
- [1]Bacher JD,Schmidt RE.Effects of autogenous cancellous bone onhealing of homogenous cortical bone grafts[J].J Small Anim Pract,2008,21:235-245.
- [2]Ito Z,Matsuyama Y,Sakai Y,et al.Bone union rate with autologous il-iac bone versus local bone graft in posterior lumbar interbody fusion[J].Spine,2010,21:1101-1105.
- [3]Xiao LP,Jiang Y,Tian YG,et al.Primary anterior focus debridementand bone autograft with internal fixation via transperitoneal approachfor tuberculosis of lumbosacral junction[J].Zhongguo Xiu Fu ChongJian Wai Ke Za Zhi,2009,8:913-916.
- [4]李立钧,谭军,周炜.一期病灶清除同种异体骨移植治疗胸腰椎结核[J].中国矫形外科杂志,2007,9:648-655.
- [5]Lee TC,Kang L,Yang LC,et al.Transpediclar instrumnentation asan adjuct in the treatment of thoracolumbar and lumber spine tubercu-losis with early stage bone destruction[J].J Neurosurg,1999,2:163-169.
- [6]Cavuolu H,Kaya RA,Türkmenolu ON,et al.A long-term follow-up study of anterior tibial allografting and instrumentation in themanagement of thoracolumbar tuberculous spondylitis[J].NeurosurgSpine,2008,1:30-38.
- [7]Canale ST.Campbell’s operative orthopaedics[M].11th ed.Beijing:Peo-ple’s Military Medical Press,2009:1454.
- [8]Revell CM,Athanasiou KA.Success rates and immunologic responsesof autogenic,allogenic,and xenogenic treatments to repair articularcartilage defects[J].Tissue Eng Part B Rev,2009,1:1-15.