ABSTRACT
Objective To compare the clinical outcomes of cervical vertebral reconstruction using titanium mesh and nano-hydroxyapatite and polyamide 66 (n-HA/PA66) mesh as two different kinds of artificial vertebrae. Methods From January 2008 to June 2009 had surgically treated 37 cases of cervical spondylosis with anterior corpectomy for decompression, and artificial vertebrae implanted combined platescrews fixation for cervical reconstruction and fusion. As a vertebral substitution, titanium mesh were implanted in 25 cases ( group A ), and the others (12 cases, group B) were implanted with n-HA/PA66 mesh. The height of fusion space immediately postoperatively and the implanted condition were observed. The fusion rate and the JOA score were recorded to compare the clinical outcomes. Results Two groups received 6-20 ( 15.4 ±4.2 )months follow-up. When follow-up to the end grafts were already fusion. The preoperative JOA score in group A,B [(8.40 ±0.96) scores vs. (8.33 ±1.07) scores(P ＞ 0.05)] were increased to (14.36 ±0.86)scores and (14.83 ±0.71) scores after postoperatively (P＞ 0.05),but there were statistically significant differences between preoperative and postoperative each group (P＜0.05). There were 6 cases artificial vertebrae in group A and 1 case in group B subsided asymptomaticly with 100% choiceness rate. Conclusion These two kinds of artificial vertebrae could show similar outcomes in cervical vertebral reconstruction, but the n-HA/PA66 mesh has a lower subsidence rate.
ABSTRACT
Objective To investigate the efficacy of the bioactive artificial vertebrae of a nano- hydroapatite crystals and polyamide 66 composite(n-HA/PA66)to restore the height and architecture of thoracolumbar burst fracture.Methods From December 2003 to February 2006,38 patients(29 males and 9 females)with a mean age of 35.6 years(17-63 years)were treated surgically through anterior ap- proach for decompression and implanted with the bioactive artificial vertebrae of n-HA/PA66 composite to reconstruct the structure of the thoracolumbar burst fractured vertebra.Results All the patients were successfuly followed-up for an average of 8 months,ranging from 6 to 21 months.The bioaetive artificial vertebrac of n-HA/PA66 composite were fused with the receptor bone 3-4 months after operation.The neu- rological function of the patients was restored partially or completely.The thoracolumbar spine was stable during physical examination and the height of thoraeolumbar burst fractured vertebrae that had been restored did not changa during the follow-up.Conclusions Our results show the bioaetive artificial vertebrae of n-HA/PA66 can restore the height and structure of thoracolumbar burst fractured vertebrae and reconstruct the structure of the tboraeolumbar vertebrae effectively,indicating that the bioaetive artificial vertebrae of n- HA/PA66 can be used extensively in clinical spinal surgery.
ABSTRACT
Objective To discuss the application of nano-hydroapatic crystals and polyamide composite(n-HA/PA66) for artificial vertebrae in treating thoracic or lumbar vertebrae tumor.Methods A total of 14 cases suffering from thoracic or lumbar vertebrae tumor underwent deuto-total vertebrae resection via anterior approach,then canalis vertebralis was deboosted,artificial vertebrae was implanted and fixed with screw-stick system.Fourteen patients,9 male and 5 female were admitted by our hospital from Dec 2003 to Sep 2005,aged 32 to 68 years old(average 50).The tumor located at T_(11) in 2 cases,T_(12) in 2,L_1 in 5,L_2 in 5.Pathological diagnosis showed 3 cases were of aneurysmal bone cyst,5 of hemangioma,2 of giant cell tumor,3 of metastatic thoracic lumbar vertebra tumor. Results The follow-up lasted 3-18 months,mean 10 months.The rate of bone graft fusion reached 85.7%,with no loosened internal fixation or breakage of screw or stick.No screw breakage or spinal instability occurred during the follow-up.All cases were alive till follow-up finished.Conclusion If the thoracic vertebral tumor compresses spinal cord seriously,the patients should be recommended for surgical treatment.Total vertebrectomy followed by reconstruction could relieve the compression caused by tumor and restore the stabilization of spine effectively.Artificial vertebrae is the ideal substitute material for bone transplantation,for it has good biocompatibility,high security,high rate of bone graft fusion and firm fixation.