大段复合骨移植修复胸腰椎椎体肿瘤切除后骨缺损的临床应用

目的:评价胸腰椎椎体肿瘤切除后应用大段复合骨移植修复脊柱骨缺损的效果。方法:对36例胸腰椎椎体肿瘤患者行病椎全切或部分切除,采用大段复合骨(异体皮质骨段复合重组合异种骨)移植填充骨缺损,并结合内固定系统重建脊柱稳定性,评价其临床治疗效果。结果:33例患者获5~100个月(平均47个月)随访,植骨后无排异、感染、植骨塌陷等并发症,其中31例术后3~7个月(平均4.3个月)获骨性愈合,2例内植物松动。结论:胸腰椎椎体肿瘤椎体全切或部分切除后,采用大段复合骨移植结合内固定系统行脊椎前柱稳定性重建可达到早期脊柱稳定支撑和后期植骨融合固定的效果。

The use of a massive combined bone graft in vertebrectomy for neoplastic disease of the thoracic and lumbar spine

Objective:To evaluate the efficacy of a massive combined bone graft in the anterior spine after a complete or partial vertebrectomy of the thoracic or lumbar vertebral column tumors.Method:A total or partial vertebrectomy was performed at the involved thoracic or lumbar vertebral bodies in 36 patients.The resected vertebral body was reconstructed using a combined bone graft,which was composed of allogeneic bone strut and reconstituted bone xenograft.The spinal stability was supplemented with anterior instrumentation in all patients.Result:Thirty-three patients were followed up for 5 to 100 months.The average duration was 47 months.31 patients obtained an apparent solid fusion during 3 to 7 months(with an average of 4.3 months).Two patients demonstrated loss of fixation.No obvious complications were induced such as immune rejection,infection,collapse of bone graft material.Conclusion:The results suggest that this new combined bone graft material with anterior fixation provide stable biomechanical support in the early and late postoperative periods and the favorable bony fusion is achieved.