Clinical Outcome of n-HA/PA66 Composite Artificial Vertebral Body in Anterior Reconstruction of Cervical Intervertebral Disc Herniation_West China Medical Journal

Authors：

ZENG Fanwei , WANG Xiaolin , LI Jun

Dazhou Central Hospital, Dazhou, Sichuan 635000, P.R.China;

Corresponding author：

Keywords：

颈椎间盘突出; 颈椎前路; 纳米羟基磷灰石; 聚酰胺66; 椎间融合器

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【摘要】　目的　探讨纳米羟基磷灰石/聚酰胺66（nano-hydroxyapatite polyamide66，n-HA/PA66）颈椎融合器在颈椎间盘突出症前路手术重建中的临床疗效。　方法　 2008年12月-2010年6月，对14例颈椎间盘突出症患者行前路椎间盘切除、椎管减压，以n-HA/PA66椎间融合器支撑植骨、钢板螺钉内固定治疗。随访时间3～12个月，平均6.3个月；随访时以日本矫形外科学会（Japan Orthopaedic Assoctiation， JOA）评分改善率评价患者神经功能恢复情况，复查X线片评估椎间融合器植骨融合情况，包括椎间高度及椎间融合器下沉情况。　结果　 14例患者均成功完成颈椎前路减压手术以及椎间融合器的安放固定。所有患者术前症状均得到不同程度的改善，术后3、6、12个月的JOA改善率分别为87.0%、94.0%、97.0%。影像学检查显示所有患者植骨融合，椎间高度及椎间融合器的位置维持良好，无下沉、移位。　结论　 n-HA/PA66颈椎间融合器具有早期支撑稳定功能，可有效维持颈椎椎间高度；术后植骨融合率高且便于X线片观察，是颈椎间盘突出症患者前路手术植骨的理想支撑材料，但长期效果需进一步随访观察。
【Abstract】　Objective　 To evaluate the clinical effect of artificial cervical vertebra fusion apparatus of n-HA/PA66 in anterior reconstruction of cervical intervertebral disc herniation.　Methods　 From December 2008 to June 2010, 14 patients with cervical intervertebral disc herniation underwent anterior cervical discectomy,spinal canal decompression,spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. The patients were followed up for 3 to 12 months with an average of 6.3 months. Neurological function was evaluated by improvement rate of JOA score and situations of the supporting body was observed by X-ray in 3,6,and 12 months after the surgery.The intervertebral height,the 1ocations, and the fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements.　Results　 All the patients had undergone the operation successfully.The preoperative symptoms improved to varying degrees.JOA improvement rate were 87.0%, 94.0%, and 97.0% 3,6,and 12 months after the operation,respectively.Imaging studies showed that in all cases graft fusion were achieved,and cervical alignments,intervertebral height,cervical spine stability and the locations of the artificial vertebral body were well maintained.No displacement and subsidence of the artificial vertebral body occurred.　Conclusion　 n-HA/PA66 artificial vertebral body can provide early cervical spine support and stability and cervical intervertebral height.It has a high rate of graft fusion and is convenient to observe by X-ray.Therefore,n-HA/PA66 can be taken as an ideal graft for anterior degenerative cervical spine operation,but further follow-up study is still needed to evaluate the long-term effects.

Citation： ZENG Fanwei,WANG Xiaolin,LI Jun. Clinical Outcome of n-HA/PA66 Composite Artificial Vertebral Body in Anterior Reconstruction of Cervical Intervertebral Disc Herniation. West China Medical Journal, 2010, 25(11): 2032-2034. doi: Copy

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9.	蒋电明, 权正学, 欧云生, 等. n-HA/PA66复合生物活性支撑材料在重建椎体结构中的初步临床应用[J]. 重庆医学, 2007, 36(11): 1010-1012.
10.	修鹏, 刘立岷, 宋跃明, 等. 纳米羟基磷灰石/聚酰胺66椎体支撑体在脊髓型颈椎病前路手术重建中的应用[J]. 中国骨与关节外科, 2009, 2(5): 347-351.

1. 　姚本顺, 谢远军. 中医药治疗颈椎间盘突出症的临床研究进展[J]. 中国中医骨伤科杂志, 2008, 16(10): 68-69.
2. 　Bohler J, Gandemak T. Anterior plate for stabilization fracture-dislocations of the lower cervical spine[J]. J Trauma, 1980, 20(3): 203-205.
3. 　Fujiwara A, Kobayashi N, Saiki K, et al. Association of the Japanese orthopaedic association score with the oswestry disability index, roland-morris disability questionnaire, and short form 36[J]. Spine, 2003, 28(14): 1601-1607.
4. 　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[J]. 生物医学工程学杂志, 2008, 25(5): 1126-1129.
5. 　孟纯阳, 安洪, 蒋电明, 等. 新型纳米骨重建和修复材料羟基磷灰石/聚酰胺体内植入的生物相容性及安全性[J]. 中国临床康复, 2004, 29(8): 6330-6331.
6. 　蒋电明, 权正学, 欧云生, 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爆裂骨折中的应用[J]. 中华创伤杂志, 2006, 22(12): 884-885.
7. 　Kanyama M, Hashimoto T, Shigenobu K, et al. Pitfall of anteriorcervical fusion using titanium mesh and local autograft[J]. J Spine Disord Tech, 2003, 16(6): 513-515.
8. 　权正学, 蒋电明, 欧云生, 等. n-HA/PA66复合生物活性人工椎体在颈椎前路椎间融合治疗脊髓型颈椎病中的应用[J]. 重庆医学, 2008, 37(15): 1687-1689.
9. 　蒋电明, 权正学, 欧云生, 等. n-HA/PA66复合生物活性支撑材料在重建椎体结构中的初步临床应用[J]. 重庆医学, 2007, 36(11): 1010-1012.
10. 　修鹏, 刘立岷, 宋跃明, 等. 纳米羟基磷灰石/聚酰胺66椎体支撑体在脊髓型颈椎病前路手术重建中的应用[J]. 中国骨与关节外科, 2009, 2(5): 347-351.

West China Medical Journal

Clinical Outcome of n-HA/PA66 Composite Artificial Vertebral Body in Anterior Reconstruction of Cervical Intervertebral Disc Herniation

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