Long-Term Outcomes of Nano-Hydroxyapatite/Polyamide 66 Strut in Thoracolumbar Burst Fractures.

Abstract

BACKGROUND High-energy injuries, like car accidents, can cause thoracolumbar burst fractures, leading to spinal instability and cord compression. Anterior decompression with stabilization provides strong support, kyphosis correction, and bone fusion. This study evaluated long-term outcomes of using a nano-hydroxyapatite/polyamide 66 strut in 38 thoracolumbar fracture cases. MATERIAL AND METHODS Between December 2005 and December 2006, 38 patients underwent the introduced surgery of anterior-oblique approach, decompression, and interbody fusion, using n-HA/PA66 struts. The patients were followed up (FU) for at least 5 years. The neurological function was assessed by American Spinal Injury Association (ASIA) grades, the pain was evaluated by Visual Analogue Scale (VAS) score, the life quality was assessed by Oswestry Disability Index (ODI), and the radiographic results were assessed by X-ray and 3-dimensional computed tomography. RESULTS Twenty patients reached the final FU with a mean of 12.50±1.19 years. The mean surgical bleeding, surgical time, and hospitalization time were 633.50±169.0 mL, 183.30±25.41 min, and 18.35±3.05 days, respectively. VAS and ODI of preoperation had a significant difference between 1-year FU and final FU (P<0.05). At the final FU, the patients of ASIA B, C, and D recovered to E. All patients fused with a mean of 4.10±1.21months. Cobb angle and percentage of vertebral body height loss of preoperation had a significant difference between before surgery, at 1-year FU, and at final FU (P<0.05). CONCLUSIONS Long-term results of clinical and radiographic assessment of the n-HA/PA66 strut in treating thoracolumbar burst fractures could achieve satisfactory solid anterior support, effective restoration of intervertebral height, and good maintenance of thoracolumbar alignment.