医用硫酸钙人工骨在脊柱结核手术中的应用△

Application of Osteoset artificial bone implantation in surgical treatment of spinal tuberculosis

[目的]评价在脊柱结核病灶清除植骨融合并内固定术中，应用医用硫酸钙（Osteoset）人工骨与自体骨混合植骨的安全性和临床效果。[方法]自2004年4月～2006年5月间，对24例胸腰椎结核患者行一期前路病灶消除、Osteoset人工骨加自体骨植骨并内固定术。观察患者局部伤口情况，有无不良反应及脊髓神经功能恢复情况。定期影像学检查（脊柱X线片和CT扫描），对植骨融合和后凸畸形矫正的情况进行评定和分析。[结果]所有患者术后伤口均一期愈合，未见不良全身反应。随访6～24个月，平均15个月。影像学检查显示内固定位置良好，无松动；结核病灶均无复发，脊柱后凸畸形平均矫正15．2°±6．7°,末次随访畸形矫正角度未见明显丢失。术后3个月融合率达95．8％，术后6个月24例患者植骨部位均获骨性融合。[结论]Osteoset人工骨在脊柱结核手术治疗中可以补充植骨量，具有可靠的安全性和满意的临床效果，是一种优良的骨移植替代材料。

[ Objective] To assess the safety and clinical result of Osteoset artificial bone and autogenetic bone grafting ccmbined with internal fixation after radical debridement in the treatment of spinal tuberculosis. [ Method ] From April 2004 to May 2006, 24 cases with spinal tuberculosis were treated with radical debridement, Osteoset artificial bone and autogenetic bone grafting combined with internal fixation. Radiographs （X-rays and CTs ） were analyzed to access bony fusion and deformity correction. [ Result] All the patients acquired satisfactory incision healing without fever. The follow-up period ranged from 6 to 24 months （mean 15 months ）. There was no recurrence of the disease or loose instrumentation. The average Cobb＇s angle correction was （15.2°±6. 7°）. The rate of fusion was 95. 8% 3 month after operation, while it was 100% 6 month after operation. [Condusion] Osteoset artificial bone can avoid the complications of donor bone site. The early clinical outcome is satisfying.