Combinedanteriorinstrumentationandreconstructionwithnano-hydroxyapatite/polyamide66artificia

• 作 者: BinHe
• 机 构: 重庆市璧山区人民医院
• 出 处: 中华医学会第十七届骨科学术会议暨第十届COA国际学术大会
• 发表日期: 2015年4期
• 关键词: reduction cervicalvertebrae Fracture Dislocation artificialvertebrae anterio

　　Toevaluatetheclinicaleffectsofclosereductionversusopenreductioncombined anteriorinstrumentationandreconstructionwithn-HA/PA66artificialvertebralbodyonfracture dislocationoflowercervicalspineandTodiscussreasonabletreatment. Methods: Thirty-twopatientswithlowercervicalfracture-dislocationunderwenteitherclose reduction(n=17)oropenreduction(n=15)betweenJanuary2011andDecember2013were retrospectivelyreviewed.Thesecasesweredividedintotwogroupsaccordingtothetypeof reductionavailable,closereductiongroup:Preoperativeskulltractionafterinjuryormanual reductionundergeneralanesthesia;openreductiongroup:Posteriorsurgicalopenreduction or/andposteriorfixation.Afterinitialreductionn-HA/PA66artificialvertebralbodyfilledwith auto-genousbonestripsharvestedfromtheresectedvertebralbodywasimplantedintothe defectcreatedbycorpectomy.Thenanteriorinstrumentationwasperformedwithcervical anteriorplate-scrawsystem.NeurologicalimprovementwasassessedaccordingtotheAmerican SpinalInjuryAssociationgradingscale.Wealsorecordedoperationtime,bloodloss,hospitalstay andcost,C-armfluoroscopytimes,complications,radiologicalparameters,andneurological status.Results: Theneurologicalimprovement,radiologicalparametersandfunctionaloutcomeinthe twogroupsshowednostatisticallysignificantdifference,buttheoperationtime,bloodloss, hospitalstayandcost,complications,C-armfluoroscopytimes,showedthestatistically significantdifference.Inallpatients,TheX-rayfilmdemonstratedthattheheightofintervertibal spacehasrestoredandtherewasnolooseningofimplantandshiftofartificialvertebralbodyof thebiomimeticn-HA/PA66compositesgraft.Allcasesweregainedsolidfusion. Conclusion: Itiseffectivetotreatlowercervicalfracture-dislocationforbothmethodsof reductionwhichcouldrestorethecervicalspinalanatomicalalignment.Comparedwithopen reductionsurgery,closereductionhasmoreadvantages:reducingthecomplexityofoperation, stabilizationofthespine,preventingnervedamageandfurtherdeterioration,shorteroperative time,lessbloodloss,lesscomplications.Artificialvertebralbodyofthebiomimetien-HA/PA66 compositeshasagoodbiocompatibility,highsecurity,highrateofbonegraftfusionandfirm fixation,whencombinedwithcervicalanteriorinstrumentation,itcanobtainasatisfactoryclinical results.