Clinical and Radiographic Analysis of Mineralized Collagen in Posterior Lumbar Interbody Fusion
Clinical and Radiographic Analysis of Mineralized Collagen in Posterior Lumbar Interbody Fusion
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DOI：
10.1166/jbt.2014.1172
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发表时间：
2014-04
影响因子：
0.1
通讯作者：
Kui Huang;Yu Teng;Jien Zhang;H. Guo;J. E. Antezana;F. Cui;Xiaobin He
中科院分区：
文献类型：
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作者：
Kui Huang;Yu Teng;Jien Zhang;H. Guo;J. E. Antezana;F. Cui;Xiaobin He
纳米复合材料和纳米结构材料被认为在骨科研究中起着关键作用，因为骨本身就是纳米复合材料的典型例子。矿化胶原蛋白（MC）是通过仿生合成开发的，其中纳米羟基磷灰石和矿化胶原蛋白组装纤维，在组成和微观结构上都在一定程度上模仿天然骨。在这项回顾性、非随机匹配的临床研究中，将MC块作为骨移植替代物与局部骨和自体髂嵴联合植入28对接受单节段后路腰椎椎间融合术（PLIF）的患者。骨MC/局部组的平均手术时间和平均失血量显著低于髂嵴植骨组。2年后，X线片和CT扫描显示，骨MC/局部融合结果在92%的患者中明显，而自体髂嵴融合结果为94%。末次随访时，两组患者的奥斯韦斯特里功能障碍指数评分、背痛和下肢疼痛平均评分均较术前显著改善，但髂嵴内移植物中大量患者出现供区持续疼痛。在后路腰椎椎体间融合术中，使用MC骨与局部骨混合作为延长物，减少了手术时间和失血量，与自体髂骨相比，融合率令人满意，并避免了供区取髂骨的并发症。
Nanocomposites and nanostructured materials are believed to play a key role in orthopaedic research, as the bone itself being a typical example of a nanocomposite. The mineralized collagen (MC) was developed by biomimetic synthesis wherein nano hydroxyapatite and mineralized collagen assembled fibres, mimics natural bone, both composition and microstructure somewhat. In this retrospective, non-randomized matched clinical, blocks of MC as a bone graft substitute combined with the local bone and autogenously iliac crest were implanted separately in 28 pairs of patients who underwent a posterior lumbar interbody fusion at one level (PLIF). Mean operative time and mean blood loss in the group Bone MC/local were significantly lower than the group of iliac crest bone graft. After 2 years, the X-rays and CT scans revealed that the fusion result was evident in 92% of patients in the bone MC/local, compared with 94% in the autogenous iliac crest. During the final follow-up time, the Oswestry Disability Index scores, the average scores for back and leg pain showed significant improvement compared with the preoperative scores in both groups, however, a large number of patients in the graft in iliac crest presented with persistent pain at the donor site. In the posterior lumbar interbody fusion using MC bone mixed with the local bone as extender, it reduces operating time and blood loss, the rates of fusion yields were satisfactory compared to autogenous iliac crest and avoided the problem of morbidity regarding donor site harvesting iliac bone.