n-HA/PA66复合人工椎体在胸腰椎结核椎体重建的运用  

Application of n-HA/PA66 composite artificial vertebral body in the reconstruction of thoracolumbar tuberculosis vertebral body

作　　者：徐军 王宇飞[1] 张亚宁[1] XU Jun;WANG Yu-fei;ZHANG Ya-ning(Department of Spinal Orthopaedics,Linfen People's Hospital,Linfen,Shanxi 041000,China)

机构地区：[1]临汾市人民医院脊柱矫形科,山西临汾041000

出　　处：《颈腰痛杂志》2022年第3期384-386,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨纳米羟基磷灰石/聚酰胺66(nano-hydroxyapatite/polyamide 66,n-HA/PA66)复合人工椎体在胸腰椎结核椎体重建的运用效果。方法纳入2018年2月~2019年2月本院收治的32例胸腰椎结核患者,男18例,女14例,年龄(44.68±5.04)岁;ASIA分级B级3例,C级17例,D级7例,E级5例。所有患者均采用病灶清除联合n-HA/PA66复合人工椎体重建治疗,术后给予抗结核治疗。记录患者手术完成情况、并发症发生情况,术前、术后1个月、末次随访时评价后凸Cobb角、VAS评分,检测红细胞沉降率(erythrocyte sedimentation rate,ESR),末次随访时评价ASIA分级改善情况。结果所有患者均完成手术,平均用时(174.11±23.01)min,出血量(658.71±38.24)mL,住院时间(12.12±2.18)d,术后1例出现脑脊液漏,1例发生胸腔积液、1例切口感染;末次随访融合率为100%;术后1个月、末次随访时Cobb角、VAS评分、ESR均显著低于术前(P<0.05);末次随访ASIA分级较术前显著改善(P<0.05)。结论n-HA/PA66复合人工椎体用于胸腰椎结核病灶清除术后椎体重建,能够获得满意的矫正及融合效果,具有良好的椎体重建及支撑效果。Objective To explore the effect of nano-hydroxyapatite/polyamide 66(n-HA/PA66)composite artificial vertebral body in the reconstruction of thoracolumbar tuberculosis vertebral body.Methods Thirty-two thoracolumbar tuberculosis patients in our hospital from February 2018 to February 2019 were selected in this study,including 18 males and 14 females,aged(44.68±5.04)years old.Among the patients,3 cases of grade B,17 cases of grade C,7 cases of grade D,and 5 cases of grade E,which were graded according to American Spinal Injury Association(ASIA).All patients were treated with debridement combined with n-HA/PA66 composite artificial vertebral body reconstruction treatment,and anti-tuberculosis treatment was given after operation.The completion of the operation and the occurrence of complications were recorded.The kyphotic Cobb angle and pain visual analog scale(VAS)were evaluated before operation,1 month after operation,and at the last follow-up.The erythrocyte sedimentation rate(ESR)was detected.The improvement of ASIA classification was evaluated at the last follow-up.Results All patients completed the operation,the average time was(174.11±23.01)min,the blood loss was(658.71±38.24)mL,and the hospital stay was(12.12±2.18)d.Postoperative cerebrospinal fluid leakage occurred in 1 case,pleural effusion occurred in 1 case,and incision infection occurred in 1 case;the fusion rate at the last follow-up was 100%.The Cobb angle,VAS score,and ESR at 1 month after operation and the last follow-up were significantly lower than before operation(P<0.05).The ASIA classification at the last follow-up was significantly improved compared with before operation(P<0.05).Conclusion The n-HA/PA66 composite artificial vertebral body used for vertebral body reconstruction after thoracolumbar tuberculosis debridement can obtain satisfactory correction and fusion effects,and has good vertebral body reconstruction and support effects.

关 键 词：纳米羟基磷灰石/聚酰胺66复合人工椎体 胸腰椎结核 病灶清除 椎体重建 

分 类 号：R529.2[医药卫生—内科学]