自体骨髓、骨联合移植在脊柱融合中的应用

目的 探讨自体骨髓、骨联合移植在脊柱融合中的运用。方法 84例中2例半椎体畸形、8例胸椎及胸腰椎结核、10例椎体滑脱、4例下颈椎骨折、51例胸腰段骨折、6例腰椎骨折及3例退变节段不稳患者在处理原发病的同时行植骨融合术，二期再在X线监视下行经皮注射自体骨髓移植，其中74例合并应用内固定器。结果 78例获得随访，平均随访期30．06个月。75例融合成功。3例失败，其中2例二次取内固定术中才被发现，第3例术后8个月X线片有假关节形成表现，再次术中也证实有假关节形成。无神经系统症状加重的病例出现。结论 骨髓、骨联合移植在脊柱融合中运用失败率低(3．85％)，成骨性强、生物安全性好。

Autografting of bone and marrow in spinal fusion

Objective To discuss the role of autograft of bone and marrow in spinal fusion Methods 84 patients (2 hemivertebrae,8 tuberculosis,10 spondylolisthesis,4 low cervical fractures,3 intersegmental instability,51 thoracic and lumbar fractures and 6 lumbar fractures) were treated with autograft of bone in primitive operation,and were percutaneously transplanted with autogenous marrow under image intensifier after the first operation.74 cases were fixed with internal devices.Results 78 cases were followed up with average of 30 06 months.75 of these got fusion.3 patients developed nonunion,2 of 3 failures were firstly recognized in the operation of removing the internal devices,the remained one was found signs of pseudoarthrosis on X ray films taken 8 months after instrumentation and identified in the secondary operation.None of the patients had neurological deterioration.Conclusion The value of autograft of bone and marrow has been supported by the study.The compound graft materials posses much higher osteoinductive potential.With the lower nonunion rate(3 85%),the result is satisfactory.