Sathira-Angkura Vera, Kunakornsawat Sombat, Assawachutithamrong Bunsin, Tungsiripat Rachata
Institute of Orthopedics, Lerdsin General Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2011 Sep;94(9):1096-103.
To determine the outcome of hydroxyapatite (HA) mixed with autogenous bone marrow (BM) and local bone graft in posterolateral lumbar fusion.
Twenty-three patients who had posterolateral fusion with posterior instrument using HA mixed with BM and local bone graft between December 2003 and August 2005 were prospective analyzed. Degree of pain using visual analog scale (VAS) was evaluated at preoperative and 2, 4, 6, 9, 12, and 24 postoperative months. Radiographs were assessed for spinal fusion at 4, 6, 9, 12, and 24 postoperative months.
The improvement of pain was demonstrated in all patients postoperatively. Radiographic outcomes revealed solid and doubtful fusion in one of 23 patients (4.3%) and 13 of 23 patients (56.5%) at six months respectively. After two-year follow-up, one patient had solid fusion while 22 patients (95.6%) had doubtful fusion.
Despite the posterolateral lumbar fusion using HA mixed with BM and local bone graft provided good clinical results, the radiographic results of spinal fusion were questionable in most cases.
确定羟基磷灰石（HA）与自体骨髓（BM）及局部骨移植混合用于腰椎后外侧融合术的效果。
对2003年12月至2005年8月期间采用HA与BM及局部骨移植并使用后路器械进行腰椎后外侧融合术的23例患者进行前瞻性分析。采用视觉模拟量表（VAS）评估术前及术后2、4、6、9、12和24个月时的疼痛程度。在术后4、6、9、12和24个月时对X线片进行脊柱融合情况评估。
所有患者术后疼痛均有改善。X线片结果显示，术后6个月时，23例患者中有1例（4.3%）实现牢固融合，13例（56.5%）实现可疑融合。经过两年随访，1例患者实现牢固融合，22例（95.6%）患者实现可疑融合。
尽管使用HA与BM及局部骨移植进行腰椎后外侧融合术取得了良好的临床效果，但在大多数情况下，脊柱融合的X线片结果仍存在疑问。
