自体骨、同种异体骨及BMP人工合成骨治疗腰椎滑脱症的效果观察

Effect observation of autogenous bone,allograft bone and BMP synthetic bone in treatment of lumbar spondylolisthesis

目的探讨自体骨、同种异体骨、BMP人工合成骨治疗腰椎滑脱症的临床效果,为选择移植替代材料提供更多参考依据。方法选取2014年1月至2015年1月该院收治的96例腰椎滑脱患者为研究对象,采用前瞻性研究方法,按照1∶1∶1原则随机分为A(采用自体骨)、B(采用同种异体骨)和C组(采用BMP人工合成骨),每组32例;比较3组的手术相关指标、术后不良反应发生情况、椎间隙高度和植骨融合率的变化,以及术后18个月神经功能的改善情况。结果 3组患者术中出血量、术后引流量、手术时间和术后卧床时间比较,差异均无统计学意义(P>0.05)。A组和C组的不良反应发生率差异无统计学意义(P>0.05),但均明显低于B组,差异具有统计学意义(P<0.05)。A组和C组术后6、9、12、18个月的椎间隙高度差异无统计学意义,且均明显高于B组(P<0.05)。C组的植骨融合率增长较A组和B组快,术后18个月A组和C组的融合率差异无统计学意义(P>0.05),且A组和C组在每个时间段的融合率均明显高于B组,差异均有统计学意义(P<0.05)。A和C组术后18个月神经功能改善的总有效率差异无统计学意义(P>0.05),但均显著高于B组,差异具有统计学意义(P<0.05)。结论 BMP人工合成骨治疗腰椎滑脱症的临床效果与自体骨相当,但BMP人工合成骨术后植骨融合率增长较自体骨快,利于患者恢复。

Objective To explore the clinical effect of autogenous bone,allograft bone and BMP synthetic bone in the treatment of lum-bar spondylolisthesis,and provide more basis to choose transplant material.Methods A total of 96 patients with lumbar spondylolisthesis were chosen as research subjects,who were cured in our hospital from January 2014 to January 2015.They were divided into group A（who were treated with autogenous bone）,group B（who were treated with allograft bone）and group C（who were treated with BMP synthetic bone）, according to prospective study method.The indicators of the operation,postoperative adverse reactions,change of intervertebral disc height and bone graft fusion rate of three groups were compared.Results Difference of the operation indexes of three groups had no statistical sig-nificance（P 〉0.05）.The incidences of adverse reactions in group A and group C had no statistically significant difference（P 〉0.05）,but both less than that in group B,with statistically significant difference（P 〈0.05）.The intervertebral disc height after 6,9,12 and 18 months in group A and group C had no statistically significant difference（P 〉0.05）,but both more than that in group B,with statistically significant difference（P 〈0.05）.Bone graft fusion rate of group C was faster than that of group A and goup B,and the graft fusion rate in 18 month in group A and C had no statistically significant difference（P 〉0.05）.And the fusion rates of group A and C in each period were significantly higher than that of group B,with statistically significant difference（P 〈0.05）.Total effective rate of neurologic improvement in group A and group C had no statistically significant difference（P 〉0.05）,but both better than that of group B,with statistically significant difference （P 〈0.05）.Conclusion BMP synthetic bone used in lumbar spondylolisthesis has the same clinical effect as autologous bone.But BMP synthetic bone has faster bone graft fusion rate than autologous bone.And it is beneficial to patients’recovery.