Blanco J S, Sears C J
Department of Orthopedic Surgery, University of Virginia Health Sciences Center, Charlottesivlle, USA.
Spine (Phila Pa 1976). 1997 Jun 15;22(12):1338-42. doi: 10.1097/00007632-199706150-00011.
In a retrospective study, 25 patients undergoing posterior spine fusion with allograft bone and Cotrel-Dubousset Instrumentation were assessed regarding the efficacy of allograft bone use.
To determine if allograft bone use had deleterious effects regarding fusion rates and maintenance of deformity correction.
Previous studies using allograft bone in adult lumbar spine fusion models have consistently shown poor fusion rates. Studies in the pediatric population have been more favorable but in idiopathic cases have used cast or brace immobilization with Harrington instrumentation.
Twenty-five skeletally immature patients with is average age of 14 +/- 4 years and an average follow-up of 4 +/- 2 years (minimum of 3 years) were evaluated with anteroposterior, lateral, and oblique radiographs to assess the fusion mass.
Preoperative curves averaged 55.5 degrees and immediate correction averaged 58% with an average postoperative curve of 23.2 degrees. Loss of correction at final follow-up was 3.7 degrees. No pseudarthroses were identified clinically or radiographically.
Allograft bone use in the pediatric patient with idiopathic scoliosis undergoing rigid segmental instrumentation dependably results in fusion with good maintenance of correction.
在一项回顾性研究中，对25例行同种异体骨后路脊柱融合术并使用Cotrel-Dubousset器械的患者进行了同种异体骨使用效果评估。
确定同种异体骨的使用在融合率和畸形矫正维持方面是否有有害影响。
以往在成人腰椎融合模型中使用同种异体骨的研究一直显示融合率较低。儿科人群的研究结果更为乐观，但在特发性病例中，采用的是哈灵顿器械固定并辅以石膏或支具固定。
对25例骨骼未成熟患者进行评估，患者平均年龄为14±4岁，平均随访4±2年（最短3年），通过前后位、侧位和斜位X线片评估融合块情况。
术前侧弯平均为55.5度，即刻矫正平均为58%，术后平均侧弯为23.2度。末次随访时矫正丢失为3.7度。临床及影像学检查均未发现假关节形成。
在接受坚固节段性器械固定的特发性脊柱侧弯患儿中使用同种异体骨，可靠地实现了融合，并很好地维持了矫正效果。
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