寰枢椎脱位不同植骨材料及内固定方式对植骨后融合时间的影响

发布时间：2018-11-10 21:44

【摘要】：背景:后路植骨融合钉棒内固定是治疗寰枢椎脱位的常用手术方法,寰枢椎间的骨性融合是手术治疗的最终目的。目前,临床中寰枢椎后路手术可应用多种植骨材料及置钉方式,而术后患者获得植骨融合的时间也多有不同。目的:分析寰枢椎脱位后路不同植骨材料及钉棒内固定方式对植骨后融合时间的影响。方法:回顾性分析2009年8月至2015年12月286例采用寰枢椎后路植骨融合钉棒内固定并获得寰枢椎间植骨融合的可复性寰枢椎脱位患者。寰椎固定采用完全经椎弓根螺钉,枢椎固定采用椎弓根螺钉或椎板螺钉,后路植骨材料采用自体骨松质骨粒或异体骨松质骨粒。结果与结论:术后获得植骨融合时间3-24个月,C_1双侧椎弓根螺钉+C_2双侧椎弓根螺钉、C_1双侧椎弓根螺钉+C_2双侧椎板螺钉、C1双侧椎弓螺钉+C_2一侧椎弓根螺钉+C_2对侧椎板螺钉3种内固定方式对术后植骨融合时间的影响差异无显著性意义(F=2.134,P=0.120),自体骨松质骨粒和异体骨松质骨粒2种植骨材料术后植骨融合时间差异有显著性意义(F=83.611,P=0.000),内固定方式和植骨材料间无交互作用(F=1.036,P=0.356)。说明不同寰枢椎后路钉棒内固定方式均可提供稳定可靠的植骨融合环境,自体骨材料植骨更加有利于术后获得植骨融合,缩短融合时间。
[Abstract]:Background: posterior fusion screw fixation is a common operative method in the treatment of atlantoaxial dislocation, and bone fusion between atlantoaxial vertebrae is the ultimate goal of surgical treatment. At present, the posterior approach of atlantoaxial surgery can use a variety of bone graft materials and nail placement, and the time of bone graft fusion is different. Objective: to analyze the effect of different bone graft materials and screw rod fixation on the fusion time after atlantoaxial dislocation. Methods: from August 2009 to December 2015, 286 cases of atlantoaxial dislocation were treated with posterior atlantoaxial fusion screw rod fixation and fusion of atlantoaxial bone graft. Transpedicular screw was used for atlas fixation, pedicle screw or laminar screw was used for axial fixation, and autologous cancellous bone or allogeneic cancellous bone was used for posterior bone graft. Results and conclusion: the time of bone graft fusion was 3 to 24 months after operation. The pedicle screw of C _ 1 bilateral pedicle screw C _ 2 bilateral pedicle screw, C _ 1 bilateral pedicle screw C _ 2 bilateral laminar screw were obtained after operation, and C _ (1) bilateral pedicle screw, C _ (2) bilateral pedicle screw. C1 bilateral pedicle screw C2 contralateral laminar screw had no significant effect on the time of bone graft fusion (FF2.134PU 0.120). There was significant difference in the time of bone graft fusion between autologous cancellous bone grafts and allogeneic cancellous bone granulocytes 2 implants (FN 83.611P0. 000), but there was no interaction between internal fixation and bone graft materials (FN 1.036 P0. 356). The results showed that different posterior fixation methods of atlantoaxial screw and rod could provide a stable and reliable fusion environment, and autogenous bone graft was more beneficial to achieve bone graft fusion and shorten the fusion time after operation.
【作者单位】：南方医科大学研究生学院;解放军广州总医院骨科医院脊柱外科;
【基金】：广东省省级科技计划项目(2015B020233013)~~
【分类号】：R687.3

【相似文献】