BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANGBo ,  OUYunsheng , JIANGDianming , WANGXiaofeng , YANGDongjun

Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding author：

OUYunsheng, Email: ouyunsheng2001@163.com

Keywords：

Nano-hydroxyapatite/polyamide 66; Cage; Transforaminal lumbar interbody fusion; Biomechanics; Porcine

DOI：

10.7507/1002-1892.20150160

Video：

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Objective To compare the biomechanical differences between the kidney-shaped nano-hydroxyapatite/polyamide 66 (n-HA/PA66) Cage and the bullet-shaped n-HA/PA66 Cage. Methods L₂-L₅ spinal specimens were selected from 10 adult male pigs. L₂, L₃ and L₄, L₅ served as a motor unit respectively, 20 motor units altogether. They were divided into 4 groups (n=5):no treatment was given as control group (group A); nucleus pulposus resection was performed (group B); bullet-shaped Cage (group C), and kidney-shaped Cage (group D) were used in transforaminal lumbar interbody fusion (TLIF) through left intervertebral foramen and supplemented by posterior pedicle screw fixation. The intervertebral height (IH) and the position of Cages were observed on the X-ray films. The range of motion (ROM) was measured. Results There was no significant difference in the preoperative IH among 4 groups (F=0.166, P=0.917). No significant change was found in IH between at pre- and post-operation in group B (P>0.05); it increased after operation in groups C and D, but difference was not statistically significant (P>0.05). There was no significant difference in the postoperative IH among groups B, C, and D (P>0.05). The distance from Cage to the left margin was (3.06±0.51) mm in group C (close to the left) and (5.68±0.69) mm in group D (close to the middle), showing significant difference (t=6.787, P=0.000). The ROM in all directions were significantly lower in groups C and D than in groups A and B (P<0.05), and in group A than in group B (P<0.05). The right bending and compression ROM of group C were significantly higher than those of group D (P<0.05), but no statistically significant difference was found in the other direction ROM (P>0.05). Conclusion The bullet-shaped and kidney-shaped Cages have similar results in restoring IH and maintaining the stability of the spine assisted by internal fixation. Kidney-shaped Cage is more stable than bullet-shaped Cage in the axial compression and the bending load opposite implant, it can be placed in the middle and back of the vertebral body more ideally.

Citation： YANGBo, OUYunsheng, JIANGDianming, WANGXiaofeng, YANGDongjun. BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 746-750. doi: 10.7507/1002-1892.20150160 Copy

1.	Yang Meng, Chen Min-fang, Wang Hao, et al. In vitro and in vivo biocomptibility of nano-hydroxyapatite/polymide 66 as bone repair material. 中国组织工程研究与临床康复, 2010, 14(8):1513-1516.
2.	李鸿, 李玉宝, 严永刚, 等. 纳米羟基磷灰石/聚酰胺66多孔材料制备和生物安全性初步评价. 生物医学工程学杂志, 2008, 25(5):1126-1129.
3.	刘显宏, 欧云生, 蒋电明, 等. n-HA/PA66与PEEK cage在颈前路椎间盘切除减压术后椎间隙重建的比较研究. 中国临床解剖学杂志, 2012, 30(6):687-692.
4.	欧云生, 蒋电明, 权正学, 等. 纳米羟基磷灰石/聚酰胺66复合生物活性人工椎体在胸腰椎骨折前路重建手术中的应用. 中国修复重建外科杂志, 2007, 21(10):1084-1088.
5.	杨曦, 宋跃明, 孔清泉, 等. 纳米羟基磷灰石/聚酰胺66椎间融合器植骨融合治疗下腰椎退变性疾病的近期疗效. 中国修复重建外科杂志, 2012, 26(12):1425-1429.
6.	Evans JH. Biomechanics of lumbar fusion. Clin Orthop Relat Res, 1985, (193):38-46.
7.	Fukuta S, Miyamoto K, Hosoe H, et al. Kidney-type intervertebral spacers should be located anteriorly in cantilever transforaminal lumbar interbody fusion:analyses of risk factors for spacer subsidence for a minimum of 2 years. J Spinal Disord Tech, 2011, 24(3):189-195.
8.	王晓峰, 欧云生, 蒋电明, 等. 肾型n-HA/PA66腰椎间融合器在经椎间孔腰椎椎体间融合术中的有限元分析. 中国临床解剖学杂志, 2014, 32(1):67-71.
9.	Dath R, Ebinesan AD, Porter KM, et al. Anatomical measurements of porcine lumbar vertebrae. Clin Biomech (Bristol, Avon), 2007, 22(5):607-613.
10.	陆斌. 前路手术对颈椎稳定性影响的生物力学研究. 西安:第四军医大学, 2004.
11.	张振山. 自体骨腰椎椎间融合的生物力学及临床研究. 广州:广州医学院, 2011.
12.	Yang X, Song Y, Liu L, et al. Anterior reconstruction with nano-hydroxyapatite/polyamide-66 cage after thoracic and lumbar corpectomy. Orthopedics, 2012, 35(1):e66-73.
13.	刘曼, 孟耀, 周立伟, 等. 纳米羟基磷灰石/聚酰胺66复合膜的结构及成骨样细胞相容性研究. 现代口腔医学杂志, 2012, 26(1):3-7.
14.	Zhao Z, Jiang D, Ou Y, et al. A hollow cylindrical nano-hydroxyapatite/polymide composite strut for cervical reconstruction after cervical corpectomy. J Clin Neurosci, 2012, 19(4):536-540.
15.	Le TV, Baaj AA, Dakwar E, et al. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine (Phila Pa 1976), 2012, 37(14):1268-1273.
16.	Vadapalli S, Robon M, Biyani A, et al. Effect of lumbar interbody cage geometry on construct stability:a cadaveric study. Spine (Phila Pa 1976), 2006, 31(19):2189-2194.
17.	Wang ST, Goel VK, Fu CY, et al. Comparison of two interbody fusion cages for posterior lumbar interbody fusion in a cadaveric model. Int Orthop, 2006, 30(4):299-304.
18.	Hou Y, Luo Z. A Study on the structural properties of the lumbar endplate:histological structure, the effect of bone density, and spinal level. Spine (Phila Pa 1976), 2009, 34(12):E427-E433.

1. Yang Meng, Chen Min-fang, Wang Hao, et al. In vitro and in vivo biocomptibility of nano-hydroxyapatite/polymide 66 as bone repair material. 中国组织工程研究与临床康复, 2010, 14(8):1513-1516.
2. 李鸿, 李玉宝, 严永刚, 等. 纳米羟基磷灰石/聚酰胺66多孔材料制备和生物安全性初步评价. 生物医学工程学杂志, 2008, 25(5):1126-1129.
3. 刘显宏, 欧云生, 蒋电明, 等. n-HA/PA66与PEEK cage在颈前路椎间盘切除减压术后椎间隙重建的比较研究. 中国临床解剖学杂志, 2012, 30(6):687-692.
4. 欧云生, 蒋电明, 权正学, 等. 纳米羟基磷灰石/聚酰胺66复合生物活性人工椎体在胸腰椎骨折前路重建手术中的应用. 中国修复重建外科杂志, 2007, 21(10):1084-1088.
5. 杨曦, 宋跃明, 孔清泉, 等. 纳米羟基磷灰石/聚酰胺66椎间融合器植骨融合治疗下腰椎退变性疾病的近期疗效. 中国修复重建外科杂志, 2012, 26(12):1425-1429.
6. Evans JH. Biomechanics of lumbar fusion. Clin Orthop Relat Res, 1985, (193):38-46.
7. Fukuta S, Miyamoto K, Hosoe H, et al. Kidney-type intervertebral spacers should be located anteriorly in cantilever transforaminal lumbar interbody fusion:analyses of risk factors for spacer subsidence for a minimum of 2 years. J Spinal Disord Tech, 2011, 24(3):189-195.
8. 王晓峰, 欧云生, 蒋电明, 等. 肾型n-HA/PA66腰椎间融合器在经椎间孔腰椎椎体间融合术中的有限元分析. 中国临床解剖学杂志, 2014, 32(1):67-71.
9. Dath R, Ebinesan AD, Porter KM, et al. Anatomical measurements of porcine lumbar vertebrae. Clin Biomech (Bristol, Avon), 2007, 22(5):607-613.
10. 陆斌. 前路手术对颈椎稳定性影响的生物力学研究. 西安:第四军医大学, 2004.
11. 张振山. 自体骨腰椎椎间融合的生物力学及临床研究. 广州:广州医学院, 2011.
12. Yang X, Song Y, Liu L, et al. Anterior reconstruction with nano-hydroxyapatite/polyamide-66 cage after thoracic and lumbar corpectomy. Orthopedics, 2012, 35(1):e66-73.
13. 刘曼, 孟耀, 周立伟, 等. 纳米羟基磷灰石/聚酰胺66复合膜的结构及成骨样细胞相容性研究. 现代口腔医学杂志, 2012, 26(1):3-7.
14. Zhao Z, Jiang D, Ou Y, et al. A hollow cylindrical nano-hydroxyapatite/polymide composite strut for cervical reconstruction after cervical corpectomy. J Clin Neurosci, 2012, 19(4):536-540.
15. Le TV, Baaj AA, Dakwar E, et al. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine (Phila Pa 1976), 2012, 37(14):1268-1273.
16. Vadapalli S, Robon M, Biyani A, et al. Effect of lumbar interbody cage geometry on construct stability:a cadaveric study. Spine (Phila Pa 1976), 2006, 31(19):2189-2194.
17. Wang ST, Goel VK, Fu CY, et al. Comparison of two interbody fusion cages for posterior lumbar interbody fusion in a cadaveric model. Int Orthop, 2006, 30(4):299-304.
18. Hou Y, Luo Z. A Study on the structural properties of the lumbar endplate:histological structure, the effect of bone density, and spinal level. Spine (Phila Pa 1976), 2009, 34(12):E427-E433.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE

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