腰椎滑脱症椎间植骨融合中3种植骨材料的远期效果对比

摘要

背景：椎间植骨融合术是治疗腰椎滑脱症的重要方法，不同植骨材料的植骨融合的效果不尽相同，值得观察探讨。　　目的：探讨自体骨、同种异体骨、骨形成蛋白复合骨3种不同植骨材料在用于腰椎滑脱症椎间植骨时的优缺点。　　方法：119例腰椎椎体间植骨患者，分为自体骨组40例、同种异体骨组41例、骨形成蛋白复合骨组38例，进行腰椎融合分别植入自体骨、同种异体骨和骨形成蛋白复合骨，比较融合后不同时间点的椎间隙高度、植骨融合率和远期临床疗效。　　结果与结论：自体骨组、骨形成蛋白复合骨组对椎间隙高度维持显著优于同种异体骨组；3组融合速度骨形成蛋白复合骨组最快，自体骨组次之，同种异体骨组融合慢，自体骨组、骨形成蛋白复合骨组显著优于同种异体骨组(P <0.05)，骨形成蛋白复合骨组在术后9个月及12个月显著优于自体骨组(P <0.05)；Nakai评分标准3组间的优良率比较有显著性差异(P <0.05)，自体骨组、骨形成蛋白复合骨组显著优于同种异体骨组(P <0.05)。结果表明骨形成蛋白复合骨在椎间隙高度维持、植骨融合率及临床疗效等效于自体骨，优于同种异体骨。%BACKGROUND:Interbody fusion is an important method for lumbar spondylolisthesis. The effects of different bone materials require further studies. OBJECTIVE:To compare the effects of autologous bone, al ogeneic bone, bone morphogenetic protein composite bone in patients with lumbar spondylolisthesis. METHODS:Total y 119 cases of lumbar spondylolisthesis were selected and randomly divided into three groups:autologous bone group (40 cases), al ogeneic bone group (41 cases), bone morphogenetic protein composite bone group (38 cases). Intervertebral height and fusion rate were compared after fusion as wel as long-term clinical efficacy. RESULTS AND CONCLUSION:Compared with the al ogeneic bone group, autologous bone group and bone morphogenetic protein composite bone group were better in the maintenance of intervertebral height. Postoperative fusion rates were ranked as fol ows:composite bone group>autologous bone group>al ogeneic bone group (P<0.05). At 9 and 12 months postoperatively, the fusion rates in the composite bone group were better than those in the autologous bone group (P<0.05). Nakai scores in the autologous bone and composite bone groups were superior to that in the al ogeneic bone group (P<0.05). There was a significant difference in Nakai scores among the three groups (P<0.05). These findings indicate that bone morphogenetic protein composite bone is similar to autologous bone but superior to al ogeneic bone in the maintenance of intervertebral height, fusion rate and clinical efficacy.