骨移植在青少年特发性脊柱侧凸后路矫形术的应用研究

Bone graft in the posterior route surgery of adolescent idiopathic scoliosis

[目的]通过不同植骨在青少年特发性脊柱侧凸后路矫形植骨融合术中的应用比较，探讨其临床应用效果。[方法]回顾性分析2000年～2005年行后路钉-棒系统矫形手术的71例青少年特发性脊柱侧凸患者，其中自体骨移植21例（A组），同种异体骨移植23例（B组），自体骨混合同种异体骨移植27例（C组），比较随访第3、9、15、36个月的融合率、Cobb’s角丢失率及假关节发生率。[结果]A组平均融合节段7个，B组平均融合节段7．6个，C组平均融合节段8个。随访的第3个月，融合率、Cobb’s角丢失率及假关节发生率A组、B组、C组无显著性差异（P〉0．05）。第9个月，A组融合率高于B、C两组，A组与B、C组有显著性差异（P〈0．05），B、C组间无显著性差异（P〉0．05），Cobb’s角丢失率及假关节发生率A、B、C组无显著性差异（P〉0．05）。第15、36个月，融合率、Cobb’s角丢失率及假关节发生率A、B、C组无显著性差异（P〉0．05）。[结论]同种异体骨移植、白体骨混合同种异体骨移植与自体骨移植在青少年特发性脊柱侧凸后路矫形手术中对维持矫形效果可取得相近的近远期临床效果。

[ Objective] To compare the clinical resuhs of different bone graft in the posterior route spinal fusion of adolescent idiopathic scoliosis. [ Method ] A retrospective study was made in 71 case of adolescent idiopathic scoliosis, who were operated on with posterior instrumentation of screw - rod fixation system from 2000 to 2005. All of the patients were divided into three groups, autologous bone graft in 21 cases （group A）, allogous bone graft in 23 cases （group B）, autologous bone mixed allogous bone graft in 27 cases （group C） . The fusion rate, the Cobb＇s angle loss rate of incidence and pseudoarthrosis were compared among the three groups at 3, 9, 15, 36 months follow - up. [ Result] There were average number of 7, 7. 6, 8 fused segments in groups A, B, C respectively. The fusion rate, the Cobb＇ s angle loss rate of incidence and pseudoarthrosis showed no significant difference among the three groups at the 3 month follow - up （ P 〉 0. 05） . The fusion rate of group A was higher than that of group B and C （ P 〈 0. 05 ）, but no significant difference between group B and C （ P 〉 0. 05 ）, the Cobb＇ s angle loss rate of incidence and pseudoarthrosis showed no significant difference among the three groups at the 9 months follow - up （P 〉 0.05 ） . There was no significant difference among the three groups at the 15 and 36 months follow - up （P 〉 0. 05 ） . [ Conclusion] There are same recent and long- term clinical results with the three different bone grafts in the posterior route spinal fusion in adolescent idiopathic scoliosis.