Kumagai Hiroshi, Abe Tetsuya, Koda Masao, Nagashima Katsuya, Miura Kousei, Mataki Kentaro, Fujii Kengo, Noguchi Hiroshi, Funayama Toru, Yamazaki Masashi
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
J Clin Neurosci. 2019 Jan;59:232-235. doi: 10.1016/j.jocn.2018.09.004. Epub 2018 Sep 20.
Lateral lumbar interbody fusion (LLIF) often requires the use of allograft or artificial bone. We used β-tricalcium phosphate artificial bone with a porosity of 57% consisting of a novel unidirectional porous structure (Affinos®) in patients (5 male and 9 female) who underwent LLIF from August 2015 as a substitute for autologous bone. We evaluated 60 graft windows in the cages at 30 intervertebral levels. To evaluate interbody bony fusion, CT multi-planar reconstruction coronal and sagittal images obtained 1 year after surgery were assessed. Intra-cage bony fusion was observed in 39 of 60 graft windows and so total bony fusion rate was 65%. Intra-cage bony fusion was confirmed in 17 of 29 (58.6%) graft windows with autologous bone and 22 of 31 (70.9%) graft windows with Affinos®. There was no significant difference in the rate of bony fusion between autologous bone and Affinos® (p = 0.418). In conclusion, the rate of bony fusion using Affinos® in LLIF cages was not inferior to that using autologous bone graft. Affinos® is a candidate for graft material in LLIF surgery and further exploration is warranted.
腰椎外侧椎间融合术（LLIF）通常需要使用同种异体骨或人工骨。自2015年8月起，我们在接受LLIF手术的患者（5名男性和9名女性）中使用了孔隙率为57%、具有新型单向多孔结构（Affinos®）的β-磷酸三钙人工骨来替代自体骨。我们在30个椎间水平的椎间融合器中评估了60个植骨窗。为评估椎间骨融合情况，对术后1年获得的CT多平面重建冠状位和矢状位图像进行了评估。60个植骨窗中有39个观察到椎间融合器内骨融合，因此总的骨融合率为65%。29个使用自体骨的植骨窗中有17个（58.6%）确认发生了椎间融合器内骨融合，31个使用Affinos®的植骨窗中有22个（70.9%）确认发生了融合。自体骨和Affinos®之间的骨融合率无显著差异（p = 0.418）。总之，在LLIF椎间融合器中使用Affinos®的骨融合率不低于使用自体骨移植的骨融合率。Affinos®是LLIF手术中植骨材料的一个候选者，值得进一步探索。
