自制同种异体皮质骨腰椎间融合器临床应用的中远期随访评价.doc

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1、自制同种异体皮质骨腰椎间融合器临床应用的中远期随访评价廖壮文、范予文，杨进顺广州医科大学附属第二医院，骨外科摘要：探讨H制一体成型式皮质骨生物型腰椎间融合器(Formingonecorticalbiologicallumberfusioncage,FOCBLFC)在腰椎后路椎间融合术的屮远期临床疗效，评价其替代金属或碳纤维腰椎椎间融合器在临床应用及椎间融合方血的合理性及冇效性。方法：对获得3年以上随访的18例应川FOCBLFC行腰椎后路椎间融合术的腰椎退行性病变患者进行临床和影像学评估，分析其手术特点、并采用VAS评分及Oswestry功能障碍指数(OswestryDisabilityInde

2、x,0DI)价评其术后腰腿痛程度及社会、生活能力情况。同时对比手术后即刻及术后3・5年以上椎间隙高度、腰椎前凸Illi度变化及椎间融合情况。结果：所有患者术后腰腿痛症状基本缓解，神经功能明显恢复，无明显手术相关并发症。术后2年均获得椎河隙坚强骨性融合，术示手术节段前凸曲度及椎间隙高度得以明显改善和维持。植入FOCBLFC最终逐渐被吸收替代，且没有病例出现移植物移位、内I古I定断裂、松脱现象。结论：一体成型式皮质骨生物型腰椎间融合器与椎弓根钉棒系统相结介使用可以实现腰椎术后屮远期稳定，改善和维持椎间隙高度及腰椎前凸Illi度，有效实现与判断椎间融合，移植物相关并发症少见，临床效果满意，可替代金属

3、或碳纤维等腰椎椎间融合器在临床上推广应用。关键词:椎间融合，异体骨，临床研究Clinicalapplicationofformingonecorticalbiologicallumberfusioncage:mediumtolong-termfollow-upevaluation./ZhuangwenLiao,ZiwenFan,JinshunYang,/theSecondAffiliatedHospitalofGutingzhouMedicalUniversity.China.Objective:ToobservethemediumtoIong-termfollow-upclinicalout

4、comesofFormingonecorticalbiologicallumberfusioncage(FOCBLFC)intheposteriorlumberinterbodyfusionandassessitsReasonablenessandeffectivenessofclinicalusingandinterbodyfusionrateasaSubstitutestometalorcarbonfibercage・Methods:18patientswhoobtainover3-5yearsfollow-upwithlumbardegenerativediseaseweretreate

5、dbyposteriordecompression,implantationofFOCBLFCandpedicalscrewfixation.TheVASandODIscoringsystemswereusedforclinicalevaluation.TheX-raytestwasperformedpreandpostoperativelyandthemovementofspinousprocess,trabeculaofbone,anclradiolucentzonewereobserved・Andtheintervertebralheightandlumbarlordosischange

6、sweremonitoredsoastoexplorethefusioncagesynostosis.Result:Allpatients,lowbackpainrelievedandnervefunctionrestored.Therearenosignificantprocedure-relatedcomplications・Allpatientsachievedbonefusionwithin2yearsfollow-upperiod.Theintervertebralheightandlumbarlordosisthelastfollow-upweresignificantlyImpr

7、ovedandmaintainedcomparedtopre-operationandimmediatepost-operation.AndtheFOCBLFCwereeventuallyabsorbedandreplaced・Therearenocasesofgraftandfixationloosening.Conclusion:FOCBLFCcaneffectivelymaintainthe