【摘要】 [目的]选用自体、同种异体冻干骨泥混合,作为腰椎滑脱症(lumbar spondylolisthesis,LS)椎体间植骨材料。并进行随访,以探讨其骨性融合效果。[方法]随机选取LS病例86例,全部病例按照植骨材料的不同分为自体骨泥组、混合骨泥组。采用腰椎后路椎体间植骨融合术(posterior lumbar interbody fusion,PLIF)。随访时间2年2个月~4年3个月,平均2年5个月。在术前、术后第3个月复查时统计患者VAS评分、Oswestry功能障碍指数(ODI,下同),同时参照JOA腰椎部分评分标准行JOA评分。同时在术后第3、12、24个月复查腰椎X线片、腰椎CT,参考Suk法进行椎体融合评价。[结果]自体骨泥组和混合骨泥组的手术时间和术中出血量没有显著差异。JOA评分示自体骨泥组的优良率达96.77%(30/31例),混合骨泥组优良率达93.02%(40/43例)。术后3个月腰椎X线片示腰椎滑脱解剖复位率为83.78%(62/74例)。83.87%(26/29例)的自体骨泥组患者和79.07%(34/43例)的混合骨泥组患者在12个月内达到骨性愈合标准。两组骨性融合效果没有显著差异。[结论]腰椎滑脱症后路自体、同种异体混合骨泥植骨可以达到较高的融合效果,临床应用效果肯定。更多还原

【Abstract】 [Objective] To analyze the effect of mixed bone cement grafting with autologous bone and allograft bone in instrumented posterolateral lumbar interbody fusion( PLIF) of lumbar spondylolisthesis. [Methods] Eighty- six patients with lumbar spondylolisthesis received PLIF treatment and divided into autologous group( 41 cases) and mixed autologous and allograft group( 45 cases) randomly. Among them,74 received a follow- up from 26 months to 29 months. VAS,ODI and JOA scores were recorded and X- ray,CT were applied to measure the height of intervertebral space at 3,12,24 months postoperatively. Suk method was used to analyze the bone fusion rates between 2 groups. [Results] No significant difference was found in operation time and blood loss between groups( P > 0. 05). 96. 77%( 30 /31 cases) and 93. 02%( 40 /43 cases) showed satisfactory clinical effects in each group respectively( P > 0. 05). 83. 87%( 26 /29 cases) and 79. 07%( 34 /43 cases) reached relatively well bone fusion in each group at 12 months postoperatively,with no significant difference( P > 0. 05). [Conclusion] Mixed bone cement frafting with autologous and allograft bone in instrumented posterolateral lumbar interbody fusin of lumbar spondylolisthesis can achieve well bone fusion effect.更多还原