Dusseldorp Joseph Richard, Mobbs Ralph J
Department of Neurosurgery, Prince of Wales Hospital, Randwick, NSW, Australia.
Eur Spine J. 2009 Sep;18(9):1386-90. doi: 10.1007/s00586-009-1108-4. Epub 2009 Aug 4.
The design of the study includes case series, technical note and review of the literature. Autogenous bone graft (autograft) harvest from the iliac crest remains the gold standard substrate for spinal fusion. Persistent donor-site pain is the most common cause of morbidity after autograft harvest, occurring in one-third of patients. Numerous techniques for reducing donor-site morbidity have been reported in the literature, including infusion of analgesics and post-harvest reconstruction of the iliac crest with ceramics, allograft or bone morphogenic protein. A case series of patients undergoing spinal fusion surgery is reported. All patients were treated with iliac crest reconstruction using Calcium Phosphate Cement and follow-up data of persistent donor-site pain was collected. Twelve patients underwent autograft harvest with iliac spine reconstruction using Calcium Phosphate Cement. 42% (5) had persistent donor-site pain (after 3 months). All pain scores were less than or equal to 2 out of 10 (mean 1.25). In conclusion, iliac spine reconstruction using Calcium Phosphate Cement following autogenous bone graft harvest is a relatively simple procedure which failed to decrease the incidence of donor-site morbidity in our patient population.
本研究设计包括病例系列、技术说明及文献综述。取自髂嵴的自体骨移植(自体骨移植)仍是脊柱融合的金标准材料。供区持续性疼痛是自体骨移植术后最常见的发病原因,三分之一的患者会出现这种情况。文献中报道了许多降低供区发病率的技术,包括注入镇痛药以及用陶瓷、同种异体骨或骨形态发生蛋白对髂嵴进行收获后重建。本文报道了一组接受脊柱融合手术患者的病例系列。所有患者均采用磷酸钙骨水泥进行髂嵴重建,并收集了供区持续性疼痛的随访数据。12例患者接受了使用磷酸钙骨水泥进行髂嵴重建的自体骨移植。42%(5例)出现供区持续性疼痛(3个月后)。所有疼痛评分均小于或等于10分中的2分(平均1.25分)。总之,自体骨移植术后使用磷酸钙骨水泥进行髂嵴重建是一个相对简单的手术,但在我们的患者群体中未能降低供区发病的发生率。