【摘要】 [目的]探讨脱矿骨纤维(DBF)作为椎间融合器填充材料应用于下腰椎退行性疾病后路切开减压植骨融合内固定手术的临床疗效。[方法]回顾性分析2013年1月～2017年12月本院应用椎弓根钉内固定系统与椎间融合器技术治疗腰椎退行性疾病的患者69例。其中,28例使用DBF作为椎间融合器填充材料,41例完全采用自体骨填充。采用日本骨科学会(JOA)评分和Oswestry功能障碍指数(ODI)评价临床疗效,影像学检查评价植骨融合效果。[结果]两组患者均顺利手术,无严重并发症。DBF组27例患者术后未见过敏反应、感染或中毒症状,无皮疹、高热。两组患者术后平均随访(21.82±6.43)个月。两组术后JOA评分与ODI指数均较术著改善,差异有统计学意义(P<0.05),术后第3、6个月DBF组JOA评分低于自体骨组,差异有统计学意义(P<0.05),术后6个月,两组ODI指数差异无统计学意义(P>0.05)。末次随访时两组间JOA和ODI评分差异均无统计学意义(P>0.05)。影像学方面,术后3、6个月DBF组融合率低于自体骨组,差异有统计学意义(P<0.05),但末次随访时,两组间融合率的差异无统计学意义(P>0.05)。[结论]脱矿骨纤维作为植骨融合材料用于下腰椎退行性疾病手术治疗疗效满意,但较自体骨融合时间延长。更多还原

【Abstract】 [Objective] To explore the reliability and validity of demineralized bone fiber(DBF) used as graft in posterior instrumented fusion for lumbar degenerative diseases. [Methods] A retrospective study was conducted on 69 patients who underwent instrumented fusion for lumbar degenerative diseases from January 2013 to December 2017. Among them, 27 patients had the intervertebral spaced implanted with DBF, while the other 42 patients with autogenous bone graft. The Japanese Orthopedics Association(JOA) score and Oswestry disability index(ODI) were used for evaluation of clinical consequences and radiographic examinations for assessment of intervertebral fusion. [Results] The patients in both groups had operation performed smoothly without serious complication. All the 27 patients in the DBF group did not have reject reaction, infection, intoxication,rash and abnormal fever. The follow-up lasted for(21.82±6.43) months on average. Both JOA and ODI scores in the two groups significantly improved after operation compared with those before operation(P<0.05). Although the DBF group got significantly lower JOA score, whereas higher ODI score than the autograft group at 3 and 6 months postoperatively(P<0.05), no statistically significant differences were proved between them at the latest follow up(P>0.05). Consistently, the fusion rate revealed by radiographs in the DBF group was significantly inferior to the autograft group at 3 and 6 months postoperatively(P<0.05), however that became not statistically significant at the latest follow up between the two groups(P>0.05). [Conclusion] The demineralized bone fiber is safe and feasible alternative for bone autograft in instrumented fusion for treatment of lumbar degenerative diseases, although it has the fusion time delayed compared the bone autograft.更多还原