重组人骨形态发生蛋白—2联合后椎弓根螺钉系统固定加椎间植骨融合治疗退变性腰椎滑脱的效果(1)
[摘要] 目的 探討重组人骨形态发生蛋白-2(rhBMP-2)联合后椎弓根螺钉系统固定加椎间植骨融合(PLIF)在退变性腰椎滑脱中的疗效分析。 方法 回顾性分析2015年5月～2016年5月武汉大学人民医院收治的50例退变性腰椎滑脱患者的临床资料，将其分为试验组30例采用rhBMP-2联合PLIF手术，对照组20例采用单纯PLIF手术。对患者术前及术后随访测量的Prolo评分、滑脱率、奥斯沃斯特里功能障碍指数(ODI)、视觉疼痛模拟评分(VAS)及腰椎融合率进行统计学分析。 结果 术后3个月、6个月两组患者ODI、VAS评分均低于术前(P < 0.05)，且试验组均低于对照组，差异有统计学意义(P < 0.05)。术后3个月、6个月试验组腰椎植骨融合率均明显高于对照组，差异有统计学意义(P < 0.05)。术后两组滑脱率低于术前(P < 0.05)，Prolo评分高于术前(P < 0.05)；且术后试验组滑脱率低于对照组(P < 0.05)，Prolo评分高于对照组，差异有统计学意义(P < 0.05)。 结论 PLIF是治疗退变性腰椎骨滑脱较为有效合理、简单易行的方法，联合使用rhBMP-2能提高手术疗效，表现为提高术后Prolo评分，降低术后ODI脊柱评分和VAS疼痛模拟评分，降低术后滑脱率和提高腰椎植骨融合率等，近期预后佳，值得临床上推广。
[关键词] 退变性腰椎滑脱；骨形态发生蛋白；rhBMP-2，PLIF；植骨融合
[中图分类号] R681.5 [文献标识码] A [文章编号] 1673-7210(2018)04(c)-0069-04
The application of rhBMP-2 combined with PLIF in the treatment of degenerative spondylolisthesis
HU Qingzhu DAI Guo YU Ling GUO Weichun
Department of Spine Surgery， Renmin Hospital of Wuhan University， Hubei Province， Wuhan 430060， China
[Abstract] Objective To investigate the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with posterior pedicle screw system fixation and intervertebral bone graft fusion (PLIF) in degenerative lumbar spondylolisthesis. Methods The clinical data of 50 patients with degenerative lumbar spondylolisthesis and treated in Renmin Hospital of Wuhan University from May 2015 to May 2016 were analyzed retrospectively， and divided into test group with 30 cases， they were treated with rhBMP-2 combined with PLIF surgery， and 20 cases in control group were treated with simple PLIF surgery. The Prolo score， slippage rate， Terry disability index (ODI)， visual analogue scale (VAS) and lumbar fusion rate in preoperative and postoperative follow-up were statistically analyzed. Results The ODI score and VAS score in the two groups at 3 months and 6 months after postoperatively were all lower than those preoperative (P < 0.05)， and the test group was lower than those of control group， the difference was statistically significant (P < 0.05). The lumbar fusion rate in the test group at 3 months and 6 months after postoperatively was all higher than control group， the difference was statistically significant (P < 0.05). The slippage rate in the two groups after postoperatively was lower than preoperative (P < 0.05)， and the Prolo score was higher than preoperative (P < 0.05)， the slippage rate in test group after postoperatively was lower than control group (P < 0.05)， and the Prolo score was higher than control group， the difference was statistically significant (P < 0.05). Conclusion PLIF is a method for the treatment of degenerative lumbar spondylolisthesis bone is effective and reasonable and simple， the combined use of rhBMP-2 can improve the curative effect， and it shows that improve the postoperative Prolo score， reduce the ODI spine score and VAS score and reduce postoperative slippage rate and improve lumbar fusion rate. The prognosis is good， and it is worth promoting clinically., http://www.100md.com(胡庆柱 代国 余铃 郭卫春)
[关键词] 退变性腰椎滑脱；骨形态发生蛋白；rhBMP-2，PLIF；植骨融合
[中图分类号] R681.5 [文献标识码] A [文章编号] 1673-7210(2018)04(c)-0069-04
The application of rhBMP-2 combined with PLIF in the treatment of degenerative spondylolisthesis
HU Qingzhu DAI Guo YU Ling GUO Weichun
Department of Spine Surgery， Renmin Hospital of Wuhan University， Hubei Province， Wuhan 430060， China
[Abstract] Objective To investigate the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with posterior pedicle screw system fixation and intervertebral bone graft fusion (PLIF) in degenerative lumbar spondylolisthesis. Methods The clinical data of 50 patients with degenerative lumbar spondylolisthesis and treated in Renmin Hospital of Wuhan University from May 2015 to May 2016 were analyzed retrospectively， and divided into test group with 30 cases， they were treated with rhBMP-2 combined with PLIF surgery， and 20 cases in control group were treated with simple PLIF surgery. The Prolo score， slippage rate， Terry disability index (ODI)， visual analogue scale (VAS) and lumbar fusion rate in preoperative and postoperative follow-up were statistically analyzed. Results The ODI score and VAS score in the two groups at 3 months and 6 months after postoperatively were all lower than those preoperative (P < 0.05)， and the test group was lower than those of control group， the difference was statistically significant (P < 0.05). The lumbar fusion rate in the test group at 3 months and 6 months after postoperatively was all higher than control group， the difference was statistically significant (P < 0.05). The slippage rate in the two groups after postoperatively was lower than preoperative (P < 0.05)， and the Prolo score was higher than preoperative (P < 0.05)， the slippage rate in test group after postoperatively was lower than control group (P < 0.05)， and the Prolo score was higher than control group， the difference was statistically significant (P < 0.05). Conclusion PLIF is a method for the treatment of degenerative lumbar spondylolisthesis bone is effective and reasonable and simple， the combined use of rhBMP-2 can improve the curative effect， and it shows that improve the postoperative Prolo score， reduce the ODI spine score and VAS score and reduce postoperative slippage rate and improve lumbar fusion rate. The prognosis is good， and it is worth promoting clinically., http://www.100md.com(胡庆柱 代国 余铃 郭卫春)