Allograft Versus Autograft in Instrumented Posterolateral Lumbar Spinal Fusion: A Randomized Control Trial
Allograft Versus Autograft in Instrumented Posterolateral Lumbar Spinal Fusion: A Randomized Control Trial
复制标题
仪器化后外侧腰椎融合术中的同种异体移植与自体移植：随机对照试验
作者：
S. Gibson;I. Mcleod;D. Wardlaw;S. Urbaniak
研究设计.为了评价所用植骨类型的临床结局，69例接受腰椎内固定融合术的患者随机接受自身骨（从髂嵴采集）或同种异体骨（来自接受全髋关节置换术的供体的新鲜冷冻股骨头）。在手术前和手术后的间隔时间进行自我完成的问卷调查。目标.比较同种异体骨和自体骨行腰椎融合术的临床结果。背景数据总结。先前的研究表明，同种异体骨在颈椎和胸椎融合手术中是有效的，但在腰椎融合中效果较差。这些研究中的大多数使用放射学方法确定融合。然而，还没有可靠的放射学评估方法达成一致。它也已被证明，影像学表现与临床结果无关。方法.共69例接受内固定后外侧腰椎融合术的患者随机接受苏格兰东北部输血服务中心的同种异体骨或髂嵴自体骨。然后对患者进行为期1年的随访，随访时间超过6年。结果接受同种异体骨移植的患者的结局评分与接受自身骨移植的患者相似，但在自体骨移植组中，供区疼痛的发生率很高，约六分之一的患者持续存在。结论.同种异体骨，以新鲜冷冻的人股骨头的形式，在后外侧腰椎融合术中提供至少与自体骨一样好的临床结果，并且完全避免任何供体部位并发症。
Study Design. To evaluate the clinical outcome respective of the type of bone graft used, 69 patients undergoing instrumented lumbar spinal fusion were randomized to receive either their own bone (harvested from the iliac crest) or allograft bone (fresh-frozen femoral head from donors undergoing total hip joint arthroplasty). Self-completed questionnaires were administered before surgery and at intervals thereafter. Objectives. To compare the clinical outcome of lumbar spinal fusion carried out using either allograft or autograft bone. Summary of Background Data. Previous studies have suggested that allograft bone is effective in cervical and thoracic fusion operations but that it is less effective in lumbar spinal fusions. Most of these studies used a radiographic means of determining fusion. However, no reliable radiologic assessment method has yet been agreed upon. It has also been shown that radiographic appearance does not correlate with clinical outcome. Methods. A total of 69 patients undergoing instrumented posterolateral lumbar spinal fusion surgery were randomized to receive either allograft bone from the North East of Scotland Blood Transfusion Service or autologous bone from the iliac crest. The patients were then followed up at 1-year intervals over 6 years regarding clinical outcome. Results. Patients receiving allograft bone had outcome scores similar to those who had received their own bone, except that in the autograft group there was a significant incidence of donor site pain that was persistent in about one sixth of patients. Conclusions. Allograft bone, in the form of fresh-frozen human femoral head, gives clinical results at least as good as autograft bone in instrumented posterolateral lumbar spinal fusion and completely avoids any donor site complications.