医用硫酸钙在腰椎后外侧融合中的成骨能力

Osteogenetic ability of calcium sulfate bone graft in posterolateral lumbar spinal fusion

目的:在腰椎后外侧融合中,通过与自体减压骨进行比较,评价医用硫酸钙在腰椎后外侧融合中的成骨能力。方法:于2004-03/2005-01选择北京大学人民医院脊柱外科行腰椎后外侧融合术使用医用硫酸钙进行植骨患者27例为观察对象,所有患者均为左侧横突间植入硫酸钙与自体减压骨1∶1混合物,右侧植入自体减压骨,术后定期复查,评价临床效果(JOA评分)、有无排斥反应及植骨融合情况(Lenke评分)。结果:纳入患者27例,26例进入结果分析,1例外地患者脱落。①随访12～21个月,平均15.3个月。术后效果良好,患者伤口I甲愈合,随访过程中无异物反应。术后JOA评分随着术后时间的延长有不同程度的增加(术后3,6,12个月分别为28.9,28.6,30.1分)。②术后3个月时硫酸钙侧Lenke评分高于自体减压骨侧,差异有显著性意义[分别为(2.3±0.5),(1.9±0.4)分,P<0.05],术后6个月及12个月时两侧差异无显著性意义(P>0.05)。结论:在腰椎后外侧融合中使用硫酸钙可以起到与自体骨相当的作用,医用硫酸钙是一种良好的骨替代材料。

AIM： To investigate the osteogenetic ability of calcium sulfate bone graft in posterolateral lumbar spinal fusion by comparing with local compression bone. METHODS： Twenty-seven patients with lumbar disorder underwent posterolateral lumbar spinal fusion with calcium sulfate bone graft in Department of spinal surgery, People＇s Hospital, Peking University from March 2004 to January 2005 were selected as subjects. In all patients, the left side of spine was treated with 1：1 ratio of calcium sulfate and local bone, and the other side with local bone. According to JOA Score hcaving rejection or not, and Lenke Score, the clinical effect and fusion condition were evaluated respectively. RESULTS： Among the 27 patients, 26 cases were involved in the result analysis and 1 foreign case was lost. ①After 12 to 21 months of follow up （mean month： 15.3 months）, surgical effect was good, the wound healed well; there was no rejection reaction in all patients. JOA score was more or less increased after operation （JOA score was separately 28.9, 28.6, 30.1 scores at 3, 6, 9 months after operation）. ②Lenke scores of calcium sulfate side was higher than that of local bone side at the 3^rd months, and there were significant differences [（2.3±0.5）, （1.9±0.4） scores, P 〈 0.05], but this difference was not found at 6 and 12 months after surgery （P 〉 0.05）. CONCLUSION： Calcium sulfate plays the similar role to local compression bone when used as a graft extender for autograft in lumbar spine fusion, indicating calcium sulfate is a good bone graft substitutes.