COVID-19 Impact on Operative Management of Pediatric Neck Abscesses

Abstract Introduction For multiple reasons, elective pediatric otolaryngology surgical procedures have declined during the COVID-19 pandemic. Objective The purpose of the present study was to assess whether the prevalence of pediatric neck abscesses managed with operative drainage decreased compared with previous years. Methods Medical records of all pediatric cases at a tertiary care children's hospital diagnosed with abscess of the neck and treated with incision and drainage were evaluated between the dates of April 1 and November 30 from 2015 to 2020. Outcomes were compared for each year from 2015 to 2019 to 2020, which included location, abscess size, duration of antibiotic treatment, microbiology, and the number of cases per year. Results A total of 201 cases were included. The mean ± standard deviation (SD) presenting age in the 2015 to 2019 group was 5.05 ± 5.03 years old and 2.24 ± 1.91 years old in the 2020 group. The mean number of cases between 2015 and 2019 was 35.6 ± 4.2, whereas the number of cases in 2020 was 23 (p = 0.002). Of those patients who underwent IV antibiotic therapy prior to presentation (n = 43), the mean number of days before admission was 1.98 ± 2.95 (n = 40) from 2015 to 2019 and 12.00 ± 10.39 (n = 3) in 2020 (p = 0.008). The percent of cases with multiple strains cultured between 2015 and 2019 was 13.4% versus 18.2% in 2020 (p = 0.007). Conclusion There was a decrease in the number of operative neck abscesses in 2020 compared with the mean number per year from 2015 to 2019. COVID-19 mitigation strategies leading to reduced transmission of other viral and bacterial illnesses and a tendency toward prolonged medical management to avoid surgery are two possible explanations.

Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? / Desempenho do diagnóstico pré-natal do espectro da placenta acreta: Os resultados falso-positivos do ultrassom são aceitáveis em ambientes com recursos limitados?

Abstract Objective The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital. Methods A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological). Results A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency. Conclusion The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.

Resumo Objetivo Recomenda-se o encaminhamento imediato de pacientes com fatores de risco para espectro placentário acreta (PAS, na sigla em inglês) para centros especializados, favorecendo assim o diagnóstico precoce e o manejo interdisciplinar. No entanto, erros diagnósticos são frequentes, mesmo em centros de referência (CRs). Buscou-se avaliar o desempenho do diagnóstico pré-natal para PAS em um hospital latino-americano. Métodos Um estudo descritivo retrospectivo incluindo pacientes encaminhados por suspeita de SAP foi realizado. Os dados dos exames de imagem do pré-natal foram comparados com os diagnósticos finais (intraoperatórios e/ou histológicos). Resultados Foram incluídos 162 pacientes no presente estudo. A idade gestacional mediana no momento da primeira ultrassonografia suspeita de PAS foi de 29 semanas, mas as pacientes chegaram ao CR de PAS com 34 semanas. A frequência de resultados falso-positivos nos hospitais de referência foi de 68,5%. Sessenta e nove pacientes foram operadas com base na suspeita de PAS com 35 semanas e houve 28,9% de falso-positivos no CR. Em 93 pacientes, o diagnóstico de PAS foi descartado no CR, com frequência de falso-negativos de 2,1%. Conclusão O diagnóstico pré-natal de PAS é melhor no CR. Entretanto, mesmo nestes centros, resultados falso-positivos são comuns; portanto, a confirmação intraoperatória do diagnóstico de SAP é essencial.

Intervenciones de enfermería en la práctica social para la salud de la persona post-operada por lesión medular / Nursing interventions in social practice for the health of people post-operated by spinal injury

INTRODUCCIÓN: El profesional de enfermería colabora en la prestación de cuidado de la salud de personas que presentan invalidez congénita y adquirida. Las consecuencias asociadas a lesiones medulares no se derivan de la lesión en sí, sino de la falta de efectividad de los servicios de atención médica. OBJETIVO: Identificar intervenciones de enfermería en la práctica social para la salud de la persona posoperada por lesión medular. MÉTODO: Estudio cualitativo, abordaje descriptivo-exploratorio. Paciente posoperado por lesión medular, (Durango, México). Se utilizó la entrevista semiestructurada en el año 2020, a través del análisis de discurso oral. RESULTADOS: Se evidenció, la presencia de barreras sociales, que coartan el pleno desarrollo y participación de la persona con discapacidad por lesión medular en su diario vivir con la familia, comunidad y sociedad. También la autonomía de la persona no sólo se coarta al hecho de realizar tareas o labores o participar con otras personas. Incluso engloba las capacidades de pensar, de decidir por ellos, decidiendo por sí solo y que estas decisiones sean respetadas por los demás. CONCLUSIONES: Se hace necesaria la contribución del profesional de enfermería en las Políticas Públicas en el ámbito local y del país donde se propongan y establezcan, estrategias acordes a la prestación de servicios: atención a la enfermedad, promoción, prevención y rehabilitación incluyéndolo en las actividades y servicios sociales; por otra parte las necesidades de las personas con discapacidades deben considerarse también en las políticas, programas y proyectos desarrollados a nivel local y nacional. Estas personas deben tener acceso a los servicios acostumbrados, sostenidos con servicios especializados para mejorar de esta manera la calidad de vida de la persona con discapacidad.

INTRODUCTION: The nursing professional collaborates in the provision of health care for people with congenital and acquired disabilities. The consequences associated with spinal cord injuries do not derive from the injury itself, but from the lack of effectiveness of medical care services. OBJECTIVE: To identify nursing interventions in social practice for the health of the post-operated person for spinal cord injury. Method: Qualitative study, descriptive-exploratory approach. Postoperative patient for spinal cord injury, (Durango, Mexico). The semi-structured interview was used in the year 2020, using oral discourse analysis. RESULTS: The presence of social barriers was evidenced, which restrict the full development and participation of the person with disabilities due to spinal cord injury in her daily life with the family, community and society. Also the autonomy of the person is not only limited to the fact of carrying out tasks or tasks or participating with other people. It even encompasses the ability to think, to decide for them, deciding for themselves and for these decisions to be respected by others. CONCLUSIONS: The contribution of the nursing professional is necessary in Public Policies at the local level and in the country where strategies according to the provision of services are proposed and established: care for illness, promotion, prevention and rehabilitation, including it in the activities and social services; on the other hand, the needs of people with disabilities must also be considered in the policies, programs and projects developed at the local and national levels. These people must have access to the usual services, supported by specialized services to improve the quality of life of the person with disabilities.

Hernia de Grynfelt resuelta por vía laparoscópica: reporte de un caso / Grynfelt ́s hernia resolved laparoscopically: a case report

RESUMEN Las hernias lumbares son una patología rara que involucra herniación de los contenidos intraabdominales o retroperitoneales a través de debilidades congénitas o adquiridas en la pared abdominal posterolateral. El tratamiento quirúrgico es el recomendado, sin embargo, la vía de abordaje aún no está estandarizada en la literatura, pero existe mucha evidencia a favor de la laparoscopía con mejores resultados en el control del dolor posoperatorio, resultados estéticos y menor estancia hospitalaria. Se presenta el caso clínico de una paciente feme-nina de 55 años con cuadro de dolor lumbar izquierdo de 6 meses de evolución que fue diagnosticada de hernia del triángulo posterior por estudio de imagen. La reparación de su defecto herniario fue con tratamiento quirúrgico por vía laparoscópica.Palabras claves: Hernia; cirugía laparoscópica; procedimientos quirúrgicos operativos; patología quirúrgica; informes de caso.

ABSTRACT Lumbar hernia are a rare pathology that involves herniation of the intra-abdominal or retroperitoneal contents through congenital or ac-quired weaknesses in the posterolateral abdominal wall. Surgical treatment is recommended, however, the approach is not yet standard-ized in the literature, but there is much evidence in favor of laparoscopy with better results in postoperative pain control, cosmetic results, and shorter hospital stay. We present the clinical case of a 55-year-old female patient with a 6-month history of left lumbar pain who was diagnosed with posterior triangle hernia by imaging study. The repair of her hernia defect was with laparoscopic surgical treatment.Keywords: Hernia; laparoscopic surgery; operative surgical procedures; surgical pathology; case report.

Síndrome de Eagle: relato de caso / Eagle Syndrome: a case report

A síndrome de Eagle é uma condição rara e com etiologia ainda não bem estabelecida, a qual se deve ter bastante suspeição para seu correto tratamento. Seu tratamento deve ser definido em conjunto com o paciente, seja ele conservador ou cirúrgico, sempre levando em consideração as expectativas do paciente, além da maior expertise do profissional na modalidade escolhida para o tratamento. Neste artigo, apresentamos uma paciente de 35 anos atendida no Hospital Felício Rocho, discutindo os diversos aspectos da doença, inclusive a modalidade de tratamento escolhida para o caso.

Eagle syndrome is a rare condition, and its etiology has not yet been well established and its correct treatment is uncertain. Its treatment must be defined together with the patient, be it conservative or surgical, always taking into consideration the patient's expectations, in addition to a solid professional expertise in the modality chosen for the treatment. In this article, we present the case of a 35-year-old patient who was admitted to the Felício Rocho Hospital and discuss the various aspects of the disease, including the treatment modality chosen for the case.

Failure of Dermal Allograft Repair of Massive Rotator Cuff Tears in Magnetic Resonance Imaging and Clinical Assessment

BACKGROUND: Massive retracted rotator cuff tears represent a therapeutic dilemma, particularly in the young and middle-aged patients who are not appropriate for a reverse total shoulder replacement. Interposition grafting using human dermal allograft offers an alternative treatment. METHODS: A retrospective review of all patients who underwent interposition grafting using human dermal allograft between December 2013 and May 2015 for massive rotator cuff tears at our tertiary referral center was performed. Preoperative and 6 month postoperative magnetic resonance imaging (MRI) assessments were performed in all patients, with postoperative graft integrity being the primary outcome measure. Clinical evaluation was performed using the Oxford shoulder score, Constant score, and Disabilities of the Arm, Shoulder and Hand (DASH) score. RESULTS: The mean age at the time of follow-up was 54 years. On MRI, 84% of grafts were seen to have failed at 6 months. Strength was grossly reduced on the operative side when supraspinatus and subscapularis were tested; despite this, Constant score (mean, 48.2) was comparable to that in the previous reports. DASH and Oxford scores were a mean of 24.94 and 37.16, respectively. CONCLUSIONS: Based on these results, in particular the MRI findings, we cannot advocate the use of dermal allograft as an interposition graft for the repair of massive rotator cuff tears.

Cirurgia do lado errado / Cirugía del lado equivocado / Surgery on the Wrong Side

RESUMO Introdução: A assistência cirúrgica tem sido indispensável na atenção em saúde. Entretanto, as falhas nos procedimentos cirúrgicos podem causar danos irreversíveis aos pacientes. Os eventos de cirurgias em local/lado errado e paciente errado é uma das complicações mais frequentes e medidas preventivas podem evitá-los em sua totalidade. Objetivo: Identificar estratégias para prevenir a ocorrência de cirurgia no local/lado errado nos serviços de assistência cirúrgica. Métodos: Tratou-se de uma revisão integrativa da literatura junto às bases de dados Medline, Science Direct, Portal Capes, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Indice Bibliográfico Español de Ciencias de la Salud (IBECS) e Cochrane Library, entre 2003 a 2015. Foram incluídos 14 artigos que apontaram como principais medidas para prevenção de cirurgia no local errado: o uso de checklist, a aplicação do protocolo universal para segurança do paciente da Organização Mundial da Saúde, a marcação do sítio a ser operado, a comunicação eficiente da equipe cirúrgica multiprofissional, além da participação do paciente, educação e sensibilização da equipe. Conclusão: A cirurgia do lado errado é um dano que pode ser evitado. Nesse sentido, ações que envolvam a equipe multiprofissional e o próprio paciente devem ser propostas constituindo uma prioridade nos serviços de saúde, visando a melhoria da segurança do paciente cirúrgico(AU)

RESUMEN Introducción: la asistencia quirúrgica ha sido indispensable en la atención sanitaria. Sin embargo, las fallas en los procedimientos quirúrgicos pueden causar daños irreversibles a los pacientes. Cirugías en el lado equivocado, lugar equivocado o paciente equivocado son de las complicaciones más frecuentes, y que las medidas preventivas pueden evitar que ocurran en su totalidad. Objetivo: identificar las estrategias para prevenir la aparición de este tipo de error en los servicios de asistencia quirúrgica. Métodos: se realizó una revisión integradora de la literatura en las bases de datos Medline, Science Direct, Portal Capes, América Latina y el Caribe Ciencias de la Salud (LILACS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS) y Cochrane Library, en el período del 2003 a 2015. Se incluyeron 14 trabajos que apuntaban como las medidas principales: el uso de una lista de verificación, la aplicación de un protocolo universal para la seguridad de la Organización Mundial de la Salud de los pacientes, el marcamiento del sitio para ser operado, la comunicación eficiente entre el equipo quirúrgico multiprofesional, además de la participación de los pacientes, la educación y la sensibilización de los profesionales. Conclusión: la cirugía en el lado equivocado puede ser evitada. En este sentido, se deben proponer actividades que suponen un equipo multidisciplinario y el paciente constituye una prioridad en los servicios de salud, destinadas a mejorar la seguridad del paciente quirúrgico(AU)

ABSTRACT Introduction: Surgical assistance has been indispensable in health care. However, failures in surgical procedures can cause irreversible damage to patients. Surgeries on the wrong side, wrong place, or to the wrong patient are the most frequent complications, while preventive measures can prevent them from occurring entirely. Objective: To identify the strategies for preventing the occurrence of this type of error in the surgical assistance services. Methods: An integrative literature review was carried out in the databases Medline, Science Direct, Portal Capes, the Latin America and the Caribbean Health Sciences (LILACS), the Spanish Bibliographic Index of Health Sciences (IBECS), and the Cochrane Library, in the period from 2003 to 2015. We included 14 works that indicated as main measures: the use of a checklist, the application of a WHO universal protocol for patient safety, marking the site to be operated, efficient communication among the multi-professional surgical team, and also patient involvement, as well as professional education and sensitization. Conclusion: Surgery on the wrong side can be avoided. In this respect, proposing activities involving both the multidisciplinary team and the patient is a priority in healthcare services, which contributes with the improvement of the surgical patient safety(AU)

Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw

OBJECTIVES: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. MATERIALS AND METHODS: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. RESULTS: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was 61.1±42.9 months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of 6.8±7.0 months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. CONCLUSION: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.

Factor Analysis of Intraoperative Radical Conversion During Partial Nephrectomy: Single Surgeon Experience

PURPOSE: Preoperative aspects and dimensions used for an anatomical (PADUA) classification is useful to predict perioperative complications and warm ischemia time. However, it remains uncertain whether PADUA classification can predict intraoperative conversion from partial nephrectomy (PN) to radical nephrectomy (RN). We evaluate whether PADUA classification parameters can predict conversion to RN during PN. MATERIALS AND METHODS: We retrospectively assessed data of 593 patients who underwent open PN and robotic PN for renal tumors by a single surgeon at a single tertiary center between December 2003 and September 2017. Intraoperative conversion to RN was performed in 17 of 593 patients who initially underwent PN. We evaluated the factors influencing the surgical modalities including PN and radical conversion cases. Then, the factors significantly associated with conversion to RN were further analyzed. RESULTS: There were no significant differences between the 2 groups in age, longitudinal location, exophytic rate, and rim or face locations of renal masses. Renal sinus involvement, urinary collecting system involvement, and renal mass size were variables that predicted radical conversion, using univariate analysis. Renal sinus involvement (odds ratio [OR], 9.075; p=0.049) and urinary collecting system involvement (OR, 3.944; p=0.029) were independent predictors of intraoperative radical conversion, using multivariate analysis. CONCLUSIONS: The PADUA classification is a useful tool to predict intraoperative conversion from PN to RN. Renal sinus involvement and urinary collecting system involvement are the best predictors of intraoperative conversion from PN to RN.

A Giant Keratoacanthoma Treated with Surgical Excision

A keratoacanthoma is a rapidly growing cutaneous tumor that spontaneously involutes in most instances. A giant keratoacanthoma is a rare variant and are characterized by lesions larger than 20 mm in diameter. We report a 56-year-old man with a rapidly growing tumor of the right cheek, which was diagnosed as keratoacanthoma. The mass was excised completely under general anesthesia, followed by Limberg flap for reconstruction. Intraoperative frozen section histology suggested the lesion to be a well-differentiated squamous cell carcinoma, whereas final histopathology was consistent with keratoacanthoma. We herein report the first case of a giant keratoacanthoma treated with surgical excision in Korea and discuss the clinical and histopathological features of keratoacanthoma, with a review of the literature.

Improved Accuracy and Safety of Intracorporeal Transpedicular Bone Grafting - using Contrast Impregnated Bone: A Case Report

A method of transpedicular bone grafting using contrast impregnated bone to improve the visualization of bone graft on the image intensifier is reported. A - 36-year old man who had sustained traumatic burst fracture of T12 vertebra, with Load-Sharing Classification (LSC) score of 8, was treated with posterior short segment fusion from T11 to L1 with transpedicular bone graft of T12 vertebra. We were able to correct the kyphotic end plate angle (EPA) from 19º to 1.4º. Anterior bone graft augmentation was achieved with contrast enhaced transpedicular bone grafts. At six months follow up, CT scan showed good bony integration of the anterior column with EPA of 4.5º and two years later, radiographs showed EPA of 7.6 º.

Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

BACKGROUND: This paper discusses the treatment protocol for patients with frostbite. METHODS: We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. RESULTS: Our clinical series of patients (n=17) included 13 men and four women, whose mean age was 42.4+/-11.6 years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7+/-3.3 days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35+/-4.3 days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. CONCLUSIONS: With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

Analysis of Procedures for Correction of Microform Cleft Lip through Strategic Approaches

BACKGROUND: Even though degrees of deformation of microform cleft lip are not high, it has to be corrected with various procedures upon conditions and areas since it has various expressions. Many studies have focused on the classifications and procedures, but there are only a few studies on how much these procedures are performed in the actual field. This study aims to analyze the utilization of various procedures upon major correction points. METHODS: A total of 52 patients who had been corrected by one surgeon from 1995 to 2011 were enrolled as subjects. Based on the medical records, it was checked whether the incision was made or not along with the correction procedures for alar base and philtral column, Cupid's bow, and vermillion free margin. RESULTS: In case of an incision, full incision (42 times) was conducted most frequently. For alar base and philtral column, muscle re-approximation (25 times) was performed most frequently. However, recently, it was shown that excision on only the affected area and correction with dermis were more likely to be used. For Cupid's bow and vermilion free margin, elliptical excision on the only affected area followed by re-approximation was performed most frequently for 46 times (Cupid's bow) and 44 times (vermilion free margin), respectively. CONCLUSION: For the correction of microform cleft lip, less invasive procedures are preferred. However, in the actual field, if needed, aggressive procedures consisting of incisions have been conducted to correction. These trends are somewhat changed to utilization of a simple procedure, such as excision on the modified area, followed by a re-approximation rather than complicated procedures using the muscle.

Endonasal Rhinoplasty / 대한이비인후과학회지

The endonasal approach for rhinoplasty is an important surgical technique to manage the majority of the nasal problem that present to the nasal plastic surgeons. Open rhinoplasty offers an excellent visualization and therefore facility of precise correction, but causes a larger area of wound and scarring. This review was designed to describe the versatility of endonasal techniques for rhinoplasty.

Colonoscopic Perforation; A 10-year Experience in Single General Hospital / 대한소화기학회지

BACKGROUND/AIMS: Colonoscopy is the principal method for diagnosis, treatment, and follow up of colorectal disease. The study aimed to assess the incidence, clinical features, and management of colonoscopic perforations at a local general hospital. METHODS: A retrospective review of patient record was performed for all patients with iatrogenic colonic perforation after sigmoidoscopy and colonoscopy between 1997 and 2007. RESULTS: In the 10-year period, 16,388 colonoscopic and sigmoidscopic procedure were performed. All 10 cases of procedure related colonic perforation were developed. Perforation occurred in 9 cases during therapeutic procedure; 5 cases due to polypectomy and 4 cases due to endoscopic submucosal dissection. Perforation occurred in one case during diagnostic procedure. CONCLUSIONS: Therapeutic procedure is a clear risk factor of colonic perforation. When colonic perforation occurs, we should be able to make early diagnosis. Early diagnosis can lead to a good treatment and can produce good prognosis with short hospital days.

Application of Artificial Vertebral Body of Biomimetic Nano-Hydroxyapatite/Polyamide 66 Composite In Anterior Surgical Treatment of Thoracolumbar Fractures / 中国修复重建外科杂志

Objective To study the clinical effects of the artificial vertebral body of the biomimetic nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite for the structural reconstruction and the height restoring of the vertebral body in the thoracolumbar fractures by the anterior surgical procedures. Methods From December 2003 to January 2006, 42 patients with thoracolumbar fractures received the anterior surgical procedures to decompress and reconstruct the spinal vertebral structure with the artificial vertebral body of the n-HA/PA66 composite. Among the patients, there were 28 males and 14 females, aged 17-67 years, averaged 43.6 years. The thoracolumbar fractures developed at T12 in 5 patients, at L1 in 17, at L2 in 14, and at L3 in 6. The height of the anterior border of the vertebral body amounted to 29%-47% of the vertebral body height, averaged 40.6%. The Cobb angle on the sagittal plane was 21-38° averaged 27.6°. According to the Frankel grading scale, the injuries to the nerves were as the following: Grade A in 7 patients, Grade B in 19, Grade C in 8, Grade D in 6, and Grade E in 2. Results All the 42 patients were followed up for 6-25 months. Among the patients, 36 were reconstructed almost based on the normal anatomic structure, and 6 were well reconstructed. The mean height of the anterior border of the vertebral body was 40.6% of the vertebral body height before operation but 91.7% after operation. And the reconstructed height of the vertebra was maintained. The mean Cobb angle on the sagittal plane was 27.6°before operation but 13.4° after operation. All the patients had a recovery of the neurological function that had a 1-grade or 2-grade improvement except 7 patients who were still in Grade A and 2 patients who were in Grade D. The implant was fused 3-5 months after operation. No infection, nail break, bar/plate break or loosening of the internal fixation occurred. Conclusion The artificial vertebral body of the biomimetic n-HA/PA66composite can effectively restore the height and the structure of the vertebra, can be fused with the vertebral body to reconstruct the spinal structural stability effectively, and can be extensively used in the clinical practice.