CAJ | 학술논문

背景：颈椎骨折诊断后多需手术治疗，前路椎体间植骨融合技术仍是目前治疗颈椎退行性或创伤性不稳的主要方法。作者设计的椭圆形同种异体骨垫，可以适应不同高度及宽度椎间隙的需要，符合椎间隙的生理形状。目的：通过与自体髂骨比较，评价自制同种异体骨垫在颈椎前路椎间植骨融合中的疗效。方法：2009年1月至2013年6月对58例颈椎椎间盘突出患者行前路一期椎间盘切除、椎间植骨融合内固定治疗，根据植骨材料不同，分为同种异体骨垫组和自体髂骨组，病程12-24个月。治疗后评价指标包括日本骨科协会(JOA)评分、颈椎间隙融合率、融合时间、手术时间、术中出血及排斥反应。结果与结论：治疗后6个月两组患者JOA评分差异无显著性意义(P>0.05)。治疗后6个月同种异体骨垫组、自体髂骨组治疗后有效融合率分别为84%和88%，差异无显著性意义(P >0.05)。同种异体骨垫组植骨融合时间较自体髂骨组长，差异有显著性意义(P<0.05)。两组内固定物均牢靠无松动，随访期间均无植骨排斥。提示与自体髂骨相比，同种异体骨垫在颈椎前路植骨融合中疗效满意，可有效融合病变椎间隙，且异体骨垫不会产生因取骨引起的取骨区疼痛等不适。
배경：경추골절진단후다수수술치료，전로추체간식골융합기술잉시목전치료경추퇴행성혹창상성불은적주요방법。작자설계적타원형동충이체골점，가이괄응불동고도급관도추간극적수요，부합추간극적생리형상。목적：통과여자체가골비교，평개자제동충이체골점재경추전로추간식골융합중적료효。방법：2009년1월지2013년6월대58례경추추간반돌출환자행전로일기추간반절제、추간식골융합내고정치료，근거식골재료불동，분위동충이체골점조화자체가골조，병정12-24개월。치료후평개지표포괄일본골과협회(JOA)평분、경추간극융합솔、융합시간、수술시간、술중출혈급배척반응。결과여결론：치료후6개월량조환자JOA평분차이무현저성의의(P>0.05)。치료후6개월동충이체골점조、자체가골조치료후유효융합솔분별위84%화88%，차이무현저성의의(P >0.05)。동충이체골점조식골융합시간교자체가골조장，차이유현저성의의(P<0.05)。량조내고정물균뢰고무송동，수방기간균무식골배척。제시여자체가골상비，동충이체골점재경추전로식골융합중료효만의，가유효융합병변추간극，차이체골점불회산생인취골인기적취골구동통등불괄。
BACKGROUND:Surgical treatment is often required for fractures of the cervical vertebrae. Anterior interbody fusion technology is stil the main method for the treatment of cervical degeneration or traumatic instability. Here, the self-made oval al ogeneic bone pad can adapt to different height and width of the intervertebral space, in line with the physiological shape of the intervertebral space. OBJECTIVE:By comparison with autogenous iliac crest bone, to evaluate various types of self-designed al ogeneic bone pads on anterior cervical interbody fusion. METHODS:From January 2009 to December 2013, 58 patients with cervical disc herniation were enrol ed and subjected to cervical discectomy and anterior cervical interbody fusion. According to different bone grafts, these patients were divided into al ogeneic bone pad and autogenous iliac bone groups. The course of disease was 12 to 24 months. The postoperative effect was measured by Japanese Orthopaedic Association (JOA) score, cervical fusion rate, fusion time, operative time, blood loss and rejection rate. RESULTS AND CONCLUSION:At 6 months postoperatively, the JOA score of two groups had no significant difference at 6 months after treatment (P>0.05);the cervical fusion rates were 83.7%and 87.8%, respectively, in the al ogeneic bone pad and autogenous iliac bone groups, with no significant difference (P>0.05). Fusion time was higher in the al ogeneic bone pad than in the autogenous iliac bone group (P<0.05). The internal fixators in the two groups were firmed without loosening, and there was no rejection during the fol ow-up. Compared with the autogenous iliac crest bone, anterior cervical interbody fusion with al ogeneic bone pad can achieve satisfactory effects, which can be better for intervertebral fusion and cannot induce pain due to bone cutting.