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目的:探讨同种异体骨移植在儿童脊柱融合术中的使用效果。方法:自1996年6月至2004年2月,对18例脊柱畸形儿童行后路畸形矫正、内固定术,术中采用同种异体骨移植,脊柱融合。同种异体骨来自髋关节置换切下的股骨头,排除乙型肝炎等传染病,经无菌封装,置于-30℃冷冻箱低温保存。使用前将股骨头裁切成骨颗粒,50℃温盐水、3%双氧水反复冲洗,充分去除骨髓。然后将骨颗粒拌和庆大霉素,植于受骨区。结果:术后均未发生切口红肿、渗出,切口均一期愈合。随访14￣72个月(32.8±17.2个月),均达到骨性融合,畸形矫正丢失角度为0°￣20°,平均为4.1°±5.3°。其中12例于术后2￣3年再次入院,行内固定物取出术,术中见植骨区均达到坚实的骨性融合。结论:冷冻保存的同种异体股骨头经简单的物理化学处理后,抗原性极弱,无明显的排异反应,用于儿童脊柱融合可获得满意的融合效果。
Objective: To investigate the effect of allogeneic bone transplantation in children with spinal fusion. Methods: From June 1996 to February 2004, 18 children with spinal deformity underwent posterior deformity correction and internal fixation. Allograft and spinal fusion were performed during operation. Allogeneic bone from the femoral head removed hip replacement, excluding hepatitis B and other infectious diseases, the aseptic packaging, placed in -30 ℃ freezer low temperature preservation. Before use, the femoral head cut into bone particles, 50 ℃ warm saline, 3% hydrogen peroxide repeatedly washed, remove the bone marrow. Then mix bone particles gentamicin, implanted in the bone area. Results: No incision swelling, exudation, incision healed in one time. Follow-up 14 ~ 72 months (32.8 ± 17.2 months), reached the bony fusion, deformity correction loss angle of 0 ° ~ 20 °, with an average of 4.1 ° ± 5.3 °. Twelve of them were admitted to the hospital again 2-3 years after operation. All the patients underwent intra-articular fixtures removal. All the bone-grafting areas in operation were found to have a solid bony fusion. Conclusion: The cryopreserved allogeneic femoral head after simple physical and chemical treatment, the antigenicity is very weak, no obvious rejection, for children with spinal fusion can obtain a satisfactory fusion effect.