同种异体骨移植治疗退行性腰椎滑脱症43例疗效观察

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1、同种异体骨移植治疗退行性腰椎滑脱症43例疗效观察作者：王丽国,孙立山,冯艳红,李书奎,李民【摘要】目的：总结同种异体骨移植治疗退行性腰椎滑脱症的疗效。方法:采用冷冻干燥辐照灭菌同种异体骨腰椎间移植治疗退行性腰椎滑脱症43例(实验组)，以同期椎间融合器结合脊柱内固定系统治疗退行性腰椎滑脱症37例作为对照组，通过临床观察、X线检查评价疗效，并进行比较。结果:实验组、对照组分别有4例和3例患者出现浅部伤口并发症(P>0.05)，分别有8例和4例患者术后体温偏高(P<0.05);随访12～36个月,实验组、对照组优良率分别为88.4%、86.5%，两组差异无统计学意义(P

2、>0.05);实验组术后平均5个月出现了骨愈合，骨性融合率达100%，术后12个月未出现移植骨的吸收;术后X线与最终随访X线片对照，实验组、对照组相对椎间隙高度丢失平均值分别为12.3%、11.9%,两组差异无统计学意义(P>0.05)。结论：冷冻干燥辐照灭菌同种异体骨椎间植骨融合治疗腰椎滑脱症，椎间融合率高，可以较好地维持椎间隙高度，无明显免疫排斥反应，疗效满意。【关键词】同种异体骨;后路腰椎椎间融合;退行性腰椎滑脱症;排异反应10　[ABSTRACT]Objective:Toevaluatetheeffectoftreatmentofdegenerativel

3、umbarspondylolisthesiswithallogeneicbonegraft.Methods:Fortypatientswithdegenerativelumbarspondylolisthesisweretreatedusingboneallograftoffreezedriedirradiationsterilization(groupA),andwascomparedwith37patientswithdegenerativelumbarspondylolisthesistreatedatthesameperiodusingintervertebralf

4、usioncagesystemandinternalfixation(groupB),theeffectswereevaluatedaccodingtoclinicalobservationandX-rayexamination.Results:FourpatientsingroupAand3patientsingroupBhadsuperficialwoundcomplications,8patientsingroupAand4patientsingroupBwithslighthigherbodytemperatureafteroperation,andthediffer

5、encesbetweenthetwogroupswerenotsignificant(P<0.05).Accordingto12～36monthsfollowup,theverygoodandgoodrateingroupAandBwas88.45%and86.5%respectively,andthedifferencebetweenthetwogroupswasnotsignificant(P>0.05).BonehealingtimeofpatientsingroupAwas5monthsbyaverage,bonefusionratewas100%;th

6、egraftedboneswereabsorbedattheendof12thmonths.AccordingtopostoperativeX-rayfilmandthefinalfollowupX-rayfilm,therelativeaveragelossofvertebralheightwere12.3%and11.9%inpatientsofgroupAand10Brespectively,andthedifferencebetweenthetwogroupswasnotsignificant(P>0.05).Conclusion:Treatmentofdeg

7、enerativelumbarspondylolisthesisusingboneallograftoffreezedriedirradiationsterilizationhassatisfactoryeffect,highinterbodyfusionrate,maintenanceofintervertebralspaceheight,andnosignificantimmunerejection.　　[KEYWORDS]Allogeneicbone;Posteriorlumbarinterbo