摘要
目的 探讨异种无机骨复合自体骨髓移植的临床应用价值。 方法 1999年 1月～ 2 0 0 2年 1月将脱蛋白、脱脂的异种无机松质骨混合自体髂骨骨髓移植 ,用于 2 1例颈椎前路减压融合术。治疗颈椎间盘突出症 9例 ,外伤性颈椎骨折脱位 12例。其中采用单纯移植 2例 ,并用前路自锁钢板 19例。 结果 术后随访 12～ 36个月 ,平均 2 1个月 ,所有患者术后正侧位 X线片见骨折复位和植骨位置良好 ,无感染等并发症。 2例颈椎间盘突出症行单纯植骨者 ,术后6个月 X线片显示植骨块塌陷 ,颈椎曲度回复至术前状态 ;其余植骨块形状无改变 ,无植骨块脱出 ,无钢板或螺钉断裂。神经功能均有不同程度恢复 ,术前 A级 10例 ,C级 7例 ,D级 4例。术后 A级中 5例未恢复 ,3例恢复至 B级 ,2例恢复至C级 ;C级 5例恢复为 D级 ,另 2例恢复为 E级 ;D级的 4例均恢复为 E级。 结论 异种无机骨复合自体骨髓可作为移植骨材料 ,用于颈椎前路融合术中 ,但其力学强度需要提高或并用坚强内固定。
Objective To study the clinical application of heterogenous bone graft combined with auto- marrow. Methods Deproteinated and degreased heterogenous cancellous bone combined with auto-marrow was used in 21 cases of anterior cervical interbody fusion. Among them, 2 cases were treated by bone graft only, and the other 19 cases were further treated by anterior plate fixation. Results The follow-up time was 12-36 months with an average of 21 months. After operation, posteroanterior and lateral radiograph of all the cases revealed that the reduction and the position of the grafting bone were good without inflammation or other complications. After 6 months of operation, the radiograph of 2 cases of cervical disk herniation, which were treated by bone graft only, showed the bones lost their height and the curve of the cervical spine returned to the state of preoperation. For the other cases, the grafting bones remained their original figure without dislocation of the bone or fracture of the plate or the screw. The nervous function recovered variously. Before operation, 10 cases were ranked as grade A, 7 cases grade C, 4 cases grade D according to Frankel classification. After operation, in grade A cases, 5 cases did not recover, 3 cases recovered to grade B, 2 cases to grade C; in grade C cases, 5 to grade D, 2 to grade E; all of grade D 4 cases to grade E. Conclusion Heterogenous bone combined with auto-marrow can be used as grafting material in the anterior cervical interbody fusion, but its mechanical rigidity need to be improved or the fusion should be aided with rigid internal fixation.
出处
《中国修复重建外科杂志》
CAS
CSCD
2004年第1期25-27,共3页
Chinese Journal of Reparative and Reconstructive Surgery
