A Novel Height-Adjustable Nano-Hydroxyapatite/Polyamide-66 Vertebral Body for Reconstruction of Thoracolumbar Structural Stability After Spinal Tumor Resection
A Novel Height-Adjustable Nano-Hydroxyapatite/Polyamide-66 Vertebral Body for Reconstruction of Thoracolumbar Structural Stability After Spinal Tumor Resection
复制标题
一种新型高度可调纳米羟基磷灰石/聚酰胺-66椎体用于脊柱肿瘤切除后重建胸腰椎结构稳定性
DOI：
10.1016/j.wneu.2018.09.213
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发表时间：
2019-02-01
影响因子：
2
通讯作者：
Liu, Tielong
中科院分区：
文献类型：
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作者：
Chen, Guanghui;Yin, Mengchen;Liu, Tielong
背景：胸腰椎结构稳定性的重建是椎体肿瘤切除术后脊柱外科医生面临的一项艰巨挑战。目前使用的可扩张或不可扩张融合器的各种缺点限制了其临床应用。我们试图开发一种新型假体用于临床，并评估其在脊柱肿瘤切除术后重建胸腰椎结构稳定性的初步临床结果。利用以前报道的研究中胸腰椎椎体和终板形态特征的回顾性分析获得的数据，我们将纳米羟基磷灰石/聚酰胺-66（n-HA/PA 66）支柱改良成一种新型高度可调节的椎体。方法：回顾性分析2016年8月至2017年1月7例胸腰椎结构稳定性重建患者的临床资料。结果：成功制备了一种新型高度可调椎体（AHVB），由n-HA/PA 66和2个单独的组件组成，每端的接触面为163 °。高度可调范围为28-37 mm，手术过程中未发生明显的种植体相关并发症。所有患者的疼痛均显著减轻，视觉模拟量表评分从7.9降至4.0。术后使用Frankel分级系统评估神经功能改善。术后X线片及CT/MRI检查结果显示，手术节段稳定，后凸畸形矫正效果良好，无假体下沉或脱位。结论：该新型假体在胸腰椎肿瘤切除术后高度、前凸和对线重建方面具有诸多优点，具有良好的临床应用前景。
BACKGROUND: Reconstruction of thoracolumbar structural stability is a formidable challenge for spine surgeons after vertebral body tumor resection. Various disadvantages of the currently used expandable or nonexpandable cages have limited their clinical applications. We sought to develop a novel prosthesis for clinical use and assess its preliminary clinical outcome in reconstruction of thoracolumbar structural stability after spinal tumor resection.METHODS: Using data obtained from a retrospective analysis of the morphological characteristics of the thoracolumbar vertebrae and endplates in previously reported studies, we modified the nano-hydroxyapatite/polyamide-66 (n-HA/PA66) strut into a novel height-adjustable vertebral body. A retrospective study was performed of 7 patients who had undergone reconstruction of thoracolumbar structural stability with this novel prosthesis from August 2016 to January 2017.RESULTS: A novel height-adjustable vertebral body (AHVB) composed of n-HA/PA66 with 2 separate components with a 163 degrees contact surface at each end was manufactured. The height-adjustable range was 28-37 mm. No significant implant-related complications were observed in the process of operation. All patients experienced a significant reduction in pain, with the visual analog scale score decreasing from 7.9 to 4.0. Neurological improvement was assessed using the Frankel grading system after surgery. Postoperative radiographic and computed tomography/magnetic resonance imaging findings indicated that the operated segment was stable, the outcome of kyphosis correction was good, and no prosthesis subsidence or dislocation was observed.CONCLUSION: This novel prosthesis has many advantages in the reconstruction of height, lordosis, and alignment after thoracolumbar spinal tumor resection and has a favorable prospect for clinical application.