周世博 1俞兴 2冯宁宁 1仇子叶 1马昱堃 1熊洋2
作者信息
- 1. 北京中医药大学,北京 100029
- 2. 北京中医药大学东直门医院,北京 100700
- 折叠
摘要
Abstract
Objective To explore the effect of nano-hydroxyapatite/collagen composite(nHAC)on bone graft fusion after anterior cervical discectomy and fusion(ACDF)in patients with cervical spondylosis and low bone mass.Methods A retro-spective analysis was conducted on 47 patients with low bone mass who underwent ACDF from 2017 to 2021.They were divid-ed into the nHAC group and the allogeneic bone group according to different bone graft materials.The nHAC group included 26 cases,with 8 males and 18 females;aged 50 to 78 years old with an average of(62.81±7.79)years old;the CT value of C2-C7 vertebrae was(264.16±36.33)HU.The allogeneic bone group included 21 cases,with 9 males and 12 females;aged 54 to 75 years old with an average of(65.95±6.58)years old;the CT value of C2-C7 vertebrae was(272.39±40.44)HU.The visual analogue scale(VAS),neck disability index(NDI),and Japanese Orthopaedic Association(JOA)spinal cord function score were compared before surgery,1 week after surgery,and at the last follow-up to evaluate the clinical efficacy.Imaging assess-ment included C2-C7 Cobb angle,surgical segment height,intervertebral fusion,and whether the cage subsidence occurred at 1 week after surgery and the last follow-up.Results The follow-up duration ranged from 26 to 39 months with an average of(33.27±3.34)months in the nHAC group and 26 to 41 months with an average of(31.86±3.57)months in the allogeneic bone group.At 1 week after surgery and the last follow-up,the VAS,NDI scores,and JOA scores in both groups were significantly improved compared with those before surgery,with statistically significant differences(P＜0.05).At 1 week after surgery,the C2-C7 Cobb angles in the nHAC group and the allogeneic bone group were(14.26±10.32)° and(14.28±8.20)° respectively,which were significantly different from those before surgery(P＜0.05).At the last follow-up,the C2-C7 Cobb angles in both groups were smaller than those at 1 week after surgery,with statistically significant differences(P＜0.05).At 1 week after surgery,the height of the surgical segment in the nHAC group was(31.65±2.55)mm,and that in the allogeneic bone group was(33.63±3.26)mm,which were significantly different from those before surgery(P＜0.05).At the last follow-up,the height of the surgical segment in both groups decreased compared with that at 1 week after surgery,with statistically significant differ-ences(P＜0.05).At the last follow-up,39 surgical segments were fused and 6 cages subsided in the nHAC group;40 surgical segments were fused and 7 cages subsided in the allogeneic bone group;there was no statistically significant difference between the two groups(P＞0.05).Compared with the CT value of vertebrae without cage subsidence,the CT value of vertebrae with cage subsidence in both groups was significantly lower,with a statistically significant difference(P＜0.05).Conclusion The application of nHAC in ACDF for patients with low bone mass can achieve effective fusion of the surgical segment.There is no significant difference in improving clinical efficacy,intervertebral fusion,and cage subsidence compared with the allogeneic bone group.With the extension of follow-up time,the C2-C7 Cobb angle decreases,the height of the surgical segment is lost,and the cage subsides in both the nHAC group and the allogeneic bone group,which may be related to low bone mass.Low bone mass may be one of the risk factors for cervical spine sequence changes,surgical segment height loss,and cage subsidence after ACDF.关键词
纳米晶胶原基骨修复材料/颈椎/前路椎间盘切除术/融合术/骨质疏松Key words
Nano-hydroxyapatite/collagen composite(nHAC)/Cervical vertebrae/Anterior discectomy/Spinal fu-sion/Osteoporosis分类
医药卫生
