Wimmer C, Krismer M, Gluch H, Ogon M, Stöckl B
Department of Orthopaedic Surgery, University of Innsbruck, Austria.
Clin Orthop Relat Res. 1999 Mar(360):122-6. doi: 10.1097/00003086-199903000-00015.
Between 1987 and 1993, 94 consecutive patients with painful spondylolisthesis underwent combined anterior and posterior fusion. The average age at operation was 40 years (range, 16-65 years). Posterior fusion was performed in all patients using pedicle screw systems, and anterior fusion was accomplished with autogenic or allogenic bone grafts. Patients retrospectively were assigned to two groups. In Group 1, anterior fusion was performed with autogenic bone grafts harvested from the iliac crest (n = 65; 146 segments) and in Group 2 allogenic bone grafts were taken from femoral heads (n = 39; 86 segments). The incidence of pseudarthrosis was evaluated on lateral tomograms 24 months after surgery. The mean clinical followup time was 4 years (range, 3-8 years). Pseudarthrosis was found in seven fused levels (3%) managed with autogenic bone grafts (Group 1) and in seven patients (8%) managed with allogenic bone grafts (Group 2). This incidence of pseudarthrosis was not significantly different between the two groups. Considering the possible complications associated with harvesting iliac crest bone, the use of allogenic bone appears justified.
1987年至1993年间，94例连续的疼痛性腰椎滑脱患者接受了前后联合融合术。手术时的平均年龄为40岁（范围16 - 65岁）。所有患者均使用椎弓根螺钉系统进行后路融合，前路融合则采用自体或异体骨移植完成。患者被回顾性地分为两组。第1组，采用取自髂嵴的自体骨移植进行前路融合（n = 65；146节段），第2组，采用取自股骨头的异体骨移植（n = 39；86节段）。术后24个月通过侧位断层片评估假关节的发生率。平均临床随访时间为4年（范围3 - 8年）。在采用自体骨移植治疗的第1组中，发现7个融合节段（3%）出现假关节，在采用异体骨移植治疗的第2组中，有7例患者（8%）出现假关节。两组间假关节的发生率无显著差异。考虑到取自髂嵴骨可能存在的并发症，使用异体骨似乎是合理的。
