Anterior reconstruction with nano-hydroxyapatite/polyamide-66 cage after thoracic and lumbar corpectomy.
Cages are used to regain stability of the anterior spinal column following vertebrectomy, which could prevent significant donor-site morbidity from the iliac autograft harvesting and the risk of disease transmission associated with the allograft. The hollow, porous, cylindrical nanohydroxyapatite/polyamide 66 (n-HA/PA66) cage is a new nonmetallic cage device made by combining nanohydroxyapatite with polyamide 66. Few studies have examined its effectiveness and outcomes over a follow-up >2 years.We retrospectively studied 51 consecutive patients with acute traumatic thoracic or lumbar burst fracture who underwent anterior reconstruction with the n-HA/PA66 cage following single-level corpectomy. Radiologic parameters (radiographs and 3-dimensional computed tomography scans) preoperatively and at 1 week and >2 years postoperatively, as well as clinical outcome parameters (SF-36 scores), were analyzed. Mean kyphosis correction in the segment within the cage was 11.8°±7.1°, and mean loss of correction at last follow-up was 1.9°±2.1°. Osseous fusion was achieved in 90.2% of patients, and severe cage subsidence (settling >2 mm) was observed in 19.6% of patients at final follow-up. Significant differences were found in 7 of 8 health dimensions of the SF-36 between neurologically intact patients and neurologically injured patients. Our clinical results indicate that the n-HA/PA66 cage is an effective device for reconstruction after anterior thoracic and lumbar vertebral resection, resulting in a high rate of successful osseous fusion and a low proportion of severe cage subsidence.
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Xi
X
Yang
Yueming
Y
Song
Limin
L
Liu
Hao
H
Liu
Jiancheng
J
Zeng
Fuxing
F
Pei
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D017886:Durapatite / Q000737:chemistry; D019544:Equipment Failure Analysis; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006801:Humans; D007796:Laminectomy / Q000295:instrumentation* / Q000379:methods; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D049329:Nanostructures / Q000737:chemistry*; D009757:Nylons / Q000737:chemistry; D011474:Prosthesis Design; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
D009757:Nylons; D017886:Durapatite