Yoshii Toshitaka, Hirai Takashi, Sakai Kenichiro, Sotome Shinichi, Enomoto Mitsuhiro, Yamada Tsuyoshi, Inose Hiroyuki, Kato Tsuyoshi, Kawabata Shigenori, Okawa Atsushi
Orthopedics. 2017 Mar 1;40(2):e334-e339. doi: 10.3928/01477447-20161208-02. Epub 2016 Dec 15.
The significant complication rate associated with harvesting autologous iliac bone or fibula has encouraged development of alternative graft substitutes. In this study, the authors investigated the efficacy and safety of synthetic porous hydroxyapatite (HA) combined with local vertebral bone graft for use in anterior cervical corpectomy and fusion (ACCF) for the treatment of patients with ossification of the posterior longitudinal ligament (OPLL). Since 2006, twenty-five OPLL patients underwent ACCF using HA blocks (HA group). Hydroxyapatite blocks with 40% porosity were used for the 1-level ACCFs, and HA blocks with 15% porosity were used for the 2-level ACCFs. Clinical and radiological evaluation was performed with a minimum of 2-year follow-up. Outcomes were compared with those of 25 OPLL patients who underwent ACCFs using auto-fibula grafts at the authors' institution before 2006 (FBG group). Patients' demographic data were similar in the HA and FBG groups. Both groups demonstrated significant neurological improvements postoperatively. No difference was observed in operating time, whereas the intraoperative blood loss was significantly less in the HA group. The fusion rates in the HA group were comparable to those in the FBG group. The incidences of general complications were similar in the 2 groups; however, prolonged donor-site pain was observed in 9 (36.0%) cases in the FBG group. Based on the results of this study, ACCF using HA is a safe and efficacious method for the treatment of patients with OPLL as an alternative to conventional ACCF using autologous fibula bone grafting. [Orthopedics. 2017; 40(2):e334-e339.].
与自体髂骨或腓骨采集相关的显著并发症发生率促使人们研发替代移植替代品。在本研究中，作者调查了合成多孔羟基磷灰石（HA）联合局部椎体骨移植在前路颈椎椎体次全切除融合术（ACCF）中用于治疗后纵韧带骨化（OPLL）患者的疗效和安全性。自2006年以来，25例OPLL患者接受了使用HA骨块的ACCF手术（HA组）。孔隙率为40%的HA骨块用于单节段ACCF，孔隙率为15%的HA骨块用于双节段ACCF。进行了至少2年随访的临床和影像学评估。将结果与2006年前在作者所在机构接受自体腓骨移植进行ACCF的25例OPLL患者的结果进行比较（FBG组）。HA组和FBG组患者的人口统计学数据相似。两组术后神经功能均有显著改善。手术时间无差异，而HA组术中出血量明显较少。HA组的融合率与FBG组相当。两组一般并发症的发生率相似；然而，FBG组有9例（36.0%）出现供区疼痛延长。基于本研究结果，使用HA进行ACCF是治疗OPLL患者的一种安全有效的方法，可替代使用自体腓骨移植的传统ACCF。[《骨科学》。2017；40（2）：e334 - e339。]
