纳米羟基磷灰石/聚酰胺66复合材料融合器行经椎间孔腰椎椎体间融合术的影像学研究

目的:将纳米羟基磷灰石/聚酰胺66(n-HA/PA66)复合材料融合器应用于经椎间孔腰椎椎体间融合术,探讨其在恢复、维持腰椎曲度和椎间高度及融合率等方面的作用及意义.方法:将2012年2月至7月符合纳入和排除标准的50例退行性腰椎疾病的患者(其中腰椎间盘突出症32例,腰椎滑脱18例),应用n-HA/PA66复合材料融合器进行经椎间孔腰椎椎体间融合术治疗,其中男34例,女16例;年龄22～64岁,平均52.16岁.术前、术后1周及术后2、4、6、8个月,分别行腰椎X线检查、腰椎三维重建CT;根据腰椎X线,测量术前、术后不同时期的腰椎曲线指数、相对椎间隙高度、Taillard指数、节段前凸角和全腰椎前凸角,并对其进行分析.结果:所有患者获得随访,时间8～13个月,平均11.32个月.术后1周腰椎曲线指数、相对椎间隙高度、Taillard指数、节段前凸角和全腰椎前凸角与术前比较差异均有统计学意义,而术后不同时期比较差异均无统计学意义.腰椎融合时间为4～8个月.结论:n-HA/PA66复合材料融合器能较好地恢复、维持腰椎正常序列、矢状面力线及稳定性,而且融合率更高、并发症少.

Radiological study on the n-HA/PA66 cage used in the transforaminal lumbar interbody fusion

Objective: To explore the effects of nano-hydroxyapatite/polyamide 66 (n-HA/PA66) cage on recovering and maintaining lumbar curvature,lumbar heights and fusion rate when used in the transforaminal lumbar interbody fusion.Methods: From February to July 2012,50 patients with degenerative lumbar disease(lumbar disc herniation in 32 cases and lumbar spondylolisthesis in 18 cases) were treated with transforaminal lumbar interbody fusion using the n-HA/PA66 cage,and their preoperative and postoperative clinical outcomes were analyzed. The patients were followed up for 2,4,6 and 8 months after operation,during which the CR and CT film of lumbar vertebra were checked to get relative height of vertebral space,Taillard index,index of lumbar spinal curvature,angle of segmental and full lumbar lordosis. The data were analyzed respectively with pair t-test,analysis of variance or LSD-t-test.Results: All the patients were followed up,and the duraion ranged from 8 to 13 months,with a mean of 11.32 months. There were significant differences in relative height of vertebral space,Taillard index,index of lumbar spinal curvature,angle of segmental and full lumbar lordosis after surgery,but there were no significant differences in different periods after operation. The fusion time of lumbar ranged from 4 to 8 months.Conclusion: The n-HA/PA66 cage can recover and maintain lumbar normal stability with higher rate of fusion and less complications.