Hydroxyapatite Block for Use in Posterolateral Lumbar Fusion: A Report of Four Cases
Hydroxyapatite Block for Use in Posterolateral Lumbar Fusion: A Report of Four Cases
复制标题
羟基磷灰石块用于后外侧腰椎融合术：附四例报告
DOI：
10.1097/00003086-200206000-00017
复制
发表时间：
2002
影响因子：
4.2
通讯作者：
M. Koono
中科院分区：
文献类型：
--
作者：
K. Totoribe;N. Tajima;E. Chosa;M. Matsumoto;H. Kataoka;M. Koono
用于腰椎后外侧融合的自体骨移植物来自髂嵴。最近，对自体骨的几种替代品进行了评估（如移植物替代品，移植物扩展剂，或两者兼而有之），结果不一。然而，尚无临床长期研究证实这些技术在腰椎后外侧融合中的疗效。本研究评估了4例患者（平均年龄66岁）后外侧融合羟基磷灰石块后5年内的影像学和组织学表现。平均随访时间为7年1个月。放射学评价采用x线平片和计算机断层扫描。1例患者进行组织学评估。毛细血管延伸到羟基磷灰石基质的多孔结构中，一些孔隙被新形成的骨组织所取代。移植替代物的长期结果是稳定的，羟基磷灰石在腰椎后外侧融合中具有一定的愈合潜力。然而，羟基磷灰石块在腰椎后外侧融合中不能作为完全的移植物替代物。因此，需要一种合适的成骨材料来诱导新骨的形成并实现牢固的结合。
Autologous bone grafts for posterolateral lumbar fusion are harvested from the iliac crests. Recently, several alternatives to autologous bone have been evaluated (such as graft substitutes, graft extenders, or both) with variable results. However, no clinical long-term studies have validated the efficacy of these techniques in posterolateral lumbar fusion. This study evaluated radiographic and histologic findings in four patients (mean age, 66 years) during the first 5 years after posterolateral fusion with an hydroxyapatite block. The mean followup was 7 years 1 month. Radiologic evaluation was by plain radiographs and computed tomography scans. Histologic evaluation was done in one patient. Capillaries extended into the porous structure of the hydroxyapatite substrate, and some of the pores were replaced by newly formed bone tissue. The long-term results of graft substitutes were stable and hydroxyapatite appeared to have some potential to achieve union in posterolateral lumbar fusion. However, hydroxyapatite block alone has not functioned effectively as a complete graft substitute in posterolateral lumbar fusion. Thus, a suitable osteogenic material is required to induce the formation of new bone and achieve a solid union.