纳米羟基磷灰石/聚酰胺66复合生物活性支撑材料对椎体结构和高度的影响

Effect of nanohydroxyapatite/polyamide 66 composite on the vertebral structure and height

背景:纳米羟基磷灰石/聚酰胺66复合物在力学属性方面和人体皮质骨十分接近,且具有成骨活性,是一种安全可靠的骨材料。目的:探讨纳米羟基磷灰石/聚酰胺66复合生物活性支撑材料在恢复椎体结构和高度中的作用。方法:纳入177例脊柱疾病患者,其中男116例,女61例,年龄17-81岁,包括97例脊柱骨折、5例脊柱原发性肿瘤、17例脊柱结核及58例颈椎病,均实施前路减压纳米羟基磷灰石/聚酰胺66复合生物活性支撑体植骨融合内固定治疗。治疗后随访36个月,进行影像学分析、Frankel脊髓损伤分级、植骨融合、目测类比评分、JOA及SF-36评分评估。结果与结论:经随访,除1例颈椎骨折患者在术后出现轻微支撑体移位之外,其余患者均未出现支撑体脱出或破裂现象,植骨融合率为96.0%,平均支撑体下沉距离为1.7 mm;与治疗前比较,脊柱骨折97例患者治疗后的神经功能得到有不同程度改善(P<0.05);177例患者的目测类比评分、JOA评分及SF-36评分较治疗前显著改善(P<0.05)。表明在脊柱重建过程中使用纳米羟基磷灰石/聚酰胺66复合生物活性支撑材料可提高植骨融合率,有效恢复椎体结构和高度。

BACKGROUND： Nanohydroxyapatite/polyamide 66 composite is very close to the human cortical bone in terms of mechanical properties,and has osteogenic activity,which is a safe and reliable bone material. OBJECTIVE： To investigate the effect of nanohydroxyapatite/polyamide 66 composite bioactive supporting material on the restoration of vertebral structure and height. METHODS： Totally 177 patients with spinal diseases,116 males and 61 females,aged 17-81 years,were enrolled,including 97 cases of spinal fractures,5 cases of primary tumors of the spine,17 cases of spinal tuberculosis and 58 cases of cervical spondylosis. The nanohydroxyapatite/polyamide 66 composite bioactive supporting body was filled into the bone grafts of patients and then subjected to anterior decompression and internal fixation. After 36 months of follow-up,imaging analysis,Frankel spinal cord injury classification,bone graft fusion,visual analog scale scores,ShortForm 36 and Japanese Orthopedic Association scores were evaluated. RESULTS AND CONCLUSION： During the follow-up,except one patient with cervical spine fracture appeared to have slight supporting body displacement,there was no supporting body prolapse or rupture phenomena. The bone graft fusion rate was 96.0%,the average supporting body sinking distance was 1.7 mm. After treatment,97 patients with spinal fractures had different degree of improvement in the neurological function（P〈0.05）; the visual analog scale scores,Short Form 36 and Japanese Orthopedic Association scores were improved significantly in all the 177 patients compared with before treatment（P〈0.05）. These results demonstrate that the use of nanohydroxyapatite/polyamide 66 composite bioactive supporting material for spinal reconstruction can improve the bone fusion rate,and restore the vertebral structure and height effectively.