Zhong Weiyang, Hu Yang
Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Orthopedic Laboratory, Chongqing Medical University, Chongqing, China.
Med Sci Monit. 2024 Dec 24;30:e946091. doi: 10.12659/MSM.946091.
BACKGROUND High-energy injuries, like car accidents, can cause thoracolumbar burst fractures, leading to spinal instability and cord compression. Anterior decompression with stabilization provides strong support, kyphosis correction, and bone fusion. This study evaluated long-term outcomes of using a nano-hydroxyapatite/polyamide 66 strut in 38 thoracolumbar fracture cases. MATERIAL AND METHODS Between December 2005 and December 2006, 38 patients underwent the introduced surgery of anterior-oblique approach, decompression, and interbody fusion, using n-HA/PA66 struts. The patients were followed up (FU) for at least 5 years. The neurological function was assessed by American Spinal Injury Association (ASIA) grades, the pain was evaluated by Visual Analogue Scale (VAS) score, the life quality was assessed by Oswestry Disability Index (ODI), and the radiographic results were assessed by X-ray and 3-dimensional computed tomography. RESULTS Twenty patients reached the final FU with a mean of 12.50±1.19 years. The mean surgical bleeding, surgical time, and hospitalization time were 633.50±169.0 mL, 183.30±25.41 min, and 18.35±3.05 days, respectively. VAS and ODI of preoperation had a significant difference between 1-year FU and final FU (P<0.05). At the final FU, the patients of ASIA B, C, and D recovered to E. All patients fused with a mean of 4.10±1.21months. Cobb angle and percentage of vertebral body height loss of preoperation had a significant difference between before surgery, at 1-year FU, and at final FU (P<0.05). CONCLUSIONS Long-term results of clinical and radiographic assessment of the n-HA/PA66 strut in treating thoracolumbar burst fractures could achieve satisfactory solid anterior support, effective restoration of intervertebral height, and good maintenance of thoracolumbar alignment.
背景 高能量损伤，如车祸，可导致胸腰椎爆裂骨折，进而引起脊柱不稳定和脊髓受压。前路减压并稳定脊柱可提供强大支撑、矫正后凸畸形并实现骨融合。本研究评估了在38例胸腰椎骨折病例中使用纳米羟基磷灰石/聚酰胺66支撑物的长期疗效。
材料与方法 2005年12月至2006年12月期间，38例患者接受了采用n-HA/PA66支撑物的前路斜入路、减压及椎间融合手术。对患者进行了至少5年的随访。通过美国脊髓损伤协会（ASIA）分级评估神经功能，通过视觉模拟评分法（VAS）评分评估疼痛程度，通过奥斯维斯特里功能障碍指数（ODI）评估生活质量，并通过X线和三维计算机断层扫描评估影像学结果。
结果 20例患者完成了最终随访，平均随访时间为12.50±1.19年。平均手术出血量、手术时间和住院时间分别为633.50±169.0 mL、183.30±25.41分钟和18.35±3.05天。术前VAS和ODI在1年随访和最终随访之间有显著差异（P<0.05）。在最终随访时，ASIA B、C和D级的患者恢复到了E级。所有患者均实现融合，平均融合时间为4.10±1.21个月。术前Cobb角和椎体高度丢失百分比在手术前、1年随访和最终随访之间有显著差异（P<0.05）。
结论 对n-HA/PA66支撑物治疗胸腰椎爆裂骨折的临床和影像学评估的长期结果显示，其可实现令人满意的坚实前路支撑、有效恢复椎间高度并良好维持胸腰椎对线。
