【摘要】 目的:探讨同种异体骨移植在儿童脊柱融合术中的使用效果。方法:自1996年6月至2004年2月,对18例脊柱畸形儿童行后路畸形矫正、内固定术,术中采用同种异体骨移植,脊柱融合。同种异体骨来自髋关节置换切下的股骨头,排除乙型肝炎等传染病,经无菌封装,置于-30℃冷冻箱低温保存。使用前将股骨头裁切成骨颗粒,50℃温盐水、3%双氧水反复冲洗,充分去除骨髓。然后将骨颗粒拌和庆大霉素,植于受骨区。结果:术后均未发生切口红肿、渗出,切口均一期愈合。随访14￣72个月(32.8±17.2个月),均达到骨性融合,畸形矫正丢失角度为0°￣20°,平均为4.1°±5.3°。其中12例于术后2￣3年再次入院,行内固定物取出术,术中见植骨区均达到坚实的骨性融合。结论:冷冻保存的同种异体股骨头经简单的物理化学处理后,抗原性极弱,无明显的排异反应,用于儿童脊柱融合可获得满意的融合效果。更多还原

【Abstract】 Objective:To determine the efficacy of allograft bone for spinal fusion in children with spinal deformities.Method:From June 1996 to Febuary 2004,eighteen children with spinal deformities were treated surgically in our department.Scoliosis or kyphosis of the spine were corrected by posterior approach,fixed with Harrington-Luque or pedicle screw and rod system,all fused with bone allograft.Bone allograft was from femoral head harvested in adult hip replacement, packed under aseptic condition, then stored in a freezer at -30℃.Before implantation,the bone was thawed in room temperature,cut into particles,washed in warm saline and hydrogen perioxide.Result:No red swelling and exudation of the incision occurred in early stage after operation in all patients,and incisions healed very well.All patients were followed up from 14 months to 72 months,with an average of 32.8±17.2 months.Bony fusion was achieved in the all patients and the loss of correction degree was 0°~20°,with an average of 4.1°±5.3°.12 of the patients underwent reoperation to remove the internal fixators from 2 years to 3 years later,during the operation,solid bone fusion was seen at implanted area.Conclusion:Bone allograft of femoral head preserved in freezer,processed physically and chemically before implantation is weak antigencity and does not induce significant rejection of the host.It is suitable alternative of bone autograft in spinal fusion in children更多还原