경추수술의 골이식 재료로서 장골과 Biocompatible Orthopaedic Polymer(BOP)에 대한 평가
The Evaluation of the llium and Biocompatible Orthopaedic Polymer(BOP) as Graft Material in Cervical Spine Surgery
소속 상세정보
신원한/Won-Han Shin
박진규/김범태/최순관/변박장/Jin-Kyu Park/Bum-Tae Kim/Soon-Kwan Choi/Bark-Jang Byun
KMID : 0359819980270060800
Abstract
결 론
저자들은 경추증과 경추손상 환자 111명에서 장골 또는 BOP를 이용하여 전방경유법으로
추체간 융합술을 시행하였고, 수술후와 추적시 방사선 검사소견, 합병증과 추적시 증상 호전
의 정도 등을 조사분석하여서 다음과 같은 결론을 얻었다.
1) 임상증상의 호전율은 장골과 BOP에서 차이가 없었다.
2) 추적시 이식골의 높이는 장골에서는 비교적 유지되지만 BOP에서 약 절반 높이로 감소
되었다.
3) 이식골의 융합 기간은 장골에서 BOP보다 3배가량 짧았다.
4) 골이식의 합병증의 발생은 장골에서 BOP보다 적었다. 재수술은 장골 1예에서 장골견
열골절로 철사고정술 그리고 BOP 1예에서 돌출로 재수술을 시행하였다.
이상의 결과로 보아 전방경유법에 의한 경추체간 융합술의 골이식 재료로서 장골과 BOP
를 어느 것이나 사용할 수 있으나, 골융합의 과정과 추체간 높이 유지면에서 장골이 BOP
보다 우수하다고 사료된다.
#초록#
Teraditional anterior interbody with autograft has limitations such as graft collapse.
graft extrusion.pseudoarthrosis. and donor site morbidity. A short hospital stay reduced
donor site complications can be achieved by using synthetic graft materials such as
Biocompatible Orthopaedic Polymer(BOP).
A retrospective study to evaluate bone graft was carried out in a series of 111
patients in whom interbody fusions were performed forcervial spondvlosis and cervial
spine injury using anterior (modified Trans-Unco-Discal) apprach with autogenous ilium
or BOP between January 1988 and December 1994 at our hospital. The radiological
assessments were made between postoperative and follow-up X-ray findings. and the
postoperative clinical results and complications were statistically analyzed.
The major results were as follows : 1) Clinical results of spondylotic patients were
graded excellent in 57%, good in 32% and fair in 11% in ilium group, and excellent
65%, good 25%, fair 5% and poor 5% in BOP group. Clinical results patients with
cervical injury were graded excellent in 25%, good in 25%, fair in 25% and poor in 25%
in ilium group, and excellent 29%, good 21%, fair 29% and poor 21% in BOP group. As
to graft materials, there were no statistically significant differance in clinical
results(p=0.76, p=0.75) 2) Mean height of graft bone were13.0㎜ in ilium group and 10.0
㎜ in BOP group at postoperative X-ray findings, and 11.6㎜ in group and 6.1㎜ in BOP
group at follow-up x-ray findings. Incidence where the height of graft bone at
follow-up X-ray findings was less than 80% of immediately postoperative height were
7% in ilium group and 58% in BOP, and there was a statistically significant
difference(P<0.05). BOP sank into the adjacent end plate as compaared to ilium. 3) Mean
duration of period required for fusion was about 40 days in ilium group and 132 days in
BOP group with a statistically significant differance(p<0.01). 4) The rate of
complications related to bone graft was 16% ilium group and 30% in BOP group,
incidence of complications was higher in BOP than ilium group. but there was no
statistically significant difference(p=0.28).
According to the above results. clinical results we were not significantly different
between both graft materials, but ilium was superior to BOP as a good spacer with
maintenance of height of graft bone and good bony fusion.
Anterior interbody fusion; Cervical spondylosis Graft material; lilum; Biocompatible orthopaedic polymer(BOP).;
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