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环形骨移植在青少年结核后凸畸形手术治疗中的应用:一项回顾性研究。

Utilization of ring-shaped bone allograft for surgical treatment of adolescent post-tubercular kyphosis: A retrospective study.

作者信息

Yin Xiang, Liu Peng, Liu Yao-Yao, Fan Wei-Li, Liu Bai-Yi, Zhao Jian-Hua

机构信息

Department of Spinal Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.

出版信息

Medicine (Baltimore). 2017 Jun;96(24):e7132. doi: 10.1097/MD.0000000000007132.

Abstract

This study aimed to investigate the mid-term outcome of ring-shaped bone allografts in the surgical treatment of adolescent post-tubercular kyphosis secondary to spinal tuberculosis.The records of adolescent patients diagnosed with spinal tuberculosis who received treatment in our department between 2009 and 2013 were retrospectively reviewed. The anterior approach was used in cases of cervical kyphosis and the posterior approach was used in cases of thoracic and lumbar kyphosis. During the surgery, the ring-shaped bone was used as a structural bone graft associated with the cancellous bone filing in the center portion of the ring shape. Cobb's angle, signs of spinal infusion on computed tomography, and complications were followed up.A total of 25 patients were included in our study. Among them, 3 involved the cervical region, 5 involved the thoracic region, 8 involved the thoracolumbar region, and 9 involved the lumbar region. The preoperative kyphosis deformity was a mean 65° Cobb's angle (40°-97°) compared to the postoperative 14° Cobb's angle (10°-21°) for an average correction of 51°. All wounds healed well without graft rejection. All patients achieved bone fusion 3 months postoperative for a 100% fusion rate.Our results show that the ring-shaped allograft bone is an effective option for the treatment of adolescent kyphosis. The ring-shaped allograft bone demonstrated satisfactory mechanical strength and vertebral fusion without mid-term metallic toxicity.

摘要

本研究旨在探讨环形同种异体骨移植治疗青少年脊柱结核继发后凸畸形的中期疗效。回顾性分析2009年至2013年在我科接受治疗的青少年脊柱结核患者的病历。颈椎后凸畸形采用前路手术,胸腰椎后凸畸形采用后路手术。手术中,环形骨用作结构性骨移植,并在环形中心部分填充松质骨。随访Cobb角、计算机断层扫描显示的脊柱融合迹象及并发症。本研究共纳入25例患者。其中,3例累及颈椎,5例累及胸椎,8例累及胸腰段,9例累及腰椎。术前后凸畸形平均Cobb角为65°(40°-97°),术后为14°(10°-21°),平均矫正51°。所有伤口愈合良好,无移植排斥反应。所有患者术后3个月均实现骨融合,融合率达100%。我们的结果表明,环形同种异体骨是治疗青少年后凸畸形的有效选择。环形同种异体骨表现出令人满意的机械强度和椎体融合,且无中期金属毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f116/5478321/a4637945407d/medi-96-e7132-g002.jpg

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