纳米人工骨在颈前路植骨融合中的应用

Application of nano-artificial bone in anterior cervical fusion

背景:纳米羟基磷灰石/聚酰胺人工骨具有良好的生物相容性与较强的组织结合力,在恢复神经功能方面具有显著作用。目的:探讨颈前路植骨融合中应用纳米羟基磷灰石/聚酰胺人工骨代替自体髂骨治疗的临床效果。方法:采用随机数字表法将96例颈椎病和颈椎创伤脱位患者均分为观察组和对照组,两组患者均进行颈前路植骨融合治疗,观察组植入纳米羟基磷灰石/聚酰胺人工骨,对照组植入自体髂骨。比较两组手术情况、植入后不同时间随访的日本骨科协会(JOA)脊髓功能评分、椎体高度丢失及植骨融合率。结果与结论:两组手术时间、术后下床活动时间、术后住院时间比较差异无显著性意义(P>0.05),观察组术中出血量显著低于对照组(P<0.05)。两组随访3,6个月及末次随访的JOA评分均高于治疗前(P<0.05),但两组间不同时间点JOA评分比较差异无显著性意义(P>0.05);两组随访6个月及末次随访的椎体高度丢失程度、植骨融合率比较差异均无显著性意义(P>0.05);两组均未发生与植骨材料相关的不良反应。表明颈前路植骨融合中应用纳米羟基磷灰石/聚酰胺人工骨具有与自体髂骨相当的临床效果。

BACKGROUND：Nano-hydroxyapatite/polyamide artificial bone has good biocompatibility and strong tissue binding force, which exerts a significant role in the recovery of neurological function. OBJECTIVE： To investigate the clinical effect of nano-hydroxyapatite/polyamide artificial bone in anterior cervical fusion. METHODS： Ninety patients with cervical spondylosis and traumatic dislocation of the cervical spine were randomized into observation group and control group. Patients in the two groups underwent nano-hydroxyapatite/polyamide artificial bone and autologous iliac bone implantation, respectively. Surgical condition, Japanese Orthopaedic Association score, vertebral height loss and bone fusion rate were compared and analyzed at different time after implantation. RESULTS AND CONCLUSION：There were no significant differences in surgical time, out of bed time, postoperative hospitalization time between the two groups （P〉0.05）, but the intraoperative blood loss was significantly lower in the observation group than the control group （P 〈 0.05）. Japanese Orthopaedic Association scores were significantly increased in the two groups at 3 and 6 months after operation and at last folow-up than before （P 〈 0.05）, but there was no difference in the Japanese Orthopaedic Association score between the two groups （P〉 0.05）. The vertebral height loss and bone fusion rate had no difference between the two groups at 6 months after operation and at the last folow-up （P 〉 0.05）. No adverse effects occurred in the two groups. These findings indicate that nano-hydroxyapatite/polyamide artificial bone has good clinical effects in anterior cervical fusion, and the treatment effect is equivalent to autologous iliac bone graft.