ABSTRACT
Laminectomy can cause the dura mater to adhere to the surrounding scar tissue, leading to soft spinal stenosis after surgery. Although artificial laminae are considered ideal substitutes, they present challenges such as insecure fixation and insufficient bionics. In this study, we fabricated a bionic titanium alloy artificial lamina using three-dimensional (3D)-printing technology and evaluated its adhesion prevention and stability after laminectomy in pigs. An in vitro biomechanical pull-out resistance test indicated that the pull-out strength of the artificial lamina was close to that of a single pedicle screw and was significantly higher than that of a cortical screw. In vivo animal implantation results indicated precise laminectomy and artificial lamina implantation, as well as a safe operation process with the assistance of guide plates. X-ray and computed tomography results indicated the well fixation of bionic titanium alloy artificial lamina and screws 10 weeks after laminectomy. The artificial lamina was not loosened after being removed from pigs (postoperative week 12), exhibiting good stability. Additionally, no adhesion was observed in the artificial lamina group, whereas a large amount of scar tissue in the spinal canal covered the dural surface in the control group. Thus, 3D-printed bionic titanium alloy artificial lamina can prevent epidural adhesion after laminectomy, while restoring the structural stability of the posterior complex, suggesting the potential of lamina substitutes for adhesion prevention after laminectomy.
Subject(s)
Laminectomy , Titanium , Alloys , Animals , Bionics , Cicatrix , Laminectomy/adverse effects , Printing, Three-Dimensional , Swine , Tissue Adhesions/prevention & controlABSTRACT
OBJECTIVE: To investigate the clinical effects of anterolateral decompression and fixation on thoracolumbar fractures complicated with incomplete paraplegia. METHODS: Thirty-six patients with thoracolumbar fractures complicated with incomplete paraplegia were treated with anterolateral decompression and fixation. RESULTS: The patients were followed up for an average of 18 months, which showed satisfactory recovery of the intervertebral space height and thoracolumbar vertebral curvature. The average Cobb's angle, spinal canal index and Frankel were improved remarkably, and none of the patients developed such complications as break or mobilization of the plate screw. CONCLUSION: Anterolateral decompression and fixation can directly and completely decompress the vertebral canal, promote the functional recovery of the spinal nerves and reconstruct the alignment of the spine as an ideal approach for treatment of thoracolumbar fractures with obvious spinal canal-occupying lesions or severe kyphos complicated with incomplete paraplegia.
Subject(s)
Decompression, Surgical/methods , Lumbar Vertebrae , Paraplegia/etiology , Spinal Fractures/surgery , Thoracic Vertebrae , Adolescent , Adult , Female , Fracture Fixation, Internal , Humans , Lumbar Vertebrae/injuries , Lumbar Vertebrae/surgery , Male , Middle Aged , Paraplegia/surgery , Spinal Fractures/complications , Thoracic Vertebrae/injuries , Thoracic Vertebrae/surgeryABSTRACT
OBJECTIVE: To analyze the surgical approaches for treating displaced proximal humeral two-and three-part fractures in elderly patients. METHODS: Nineteen elderly patients with displaced proximal humeral fractures were analyzed, including 13 patients with displaced two-part fractures and 6 with displaced three-part fractures. All the patients were treated by open reduction and fixation with humeral anatomical bone plates. RESULTS: The rate of excellent or good healing was 76.9% for two-part fractures without nonunion or humeral head necrosis, and was 66.7% for three-part fractures with a rate of humeral head necrosis of 16.7%. CONCLUSION: Displaced proximal humeral fractures in elderly patients should be managed with minimal open reduction and fixed with humeral anatomical bone plate.
