Guanghui Chen1, Mengchen Yin2, Weibo Liu1, Baoquan Xin3, Guangjian Bai3, Jian Wang4, Jing Wang1, Xin Gao1, Yang Wang1, Chao Liu1, Li Cheng5, Jianru Xiao1, Tielong Liu6. 1. Department of Orthopaedic Oncology Center, Changzheng Hospital, Second Military Medical University, Shanghai, China. 2. Department of Orthopedics, Longhua Hospital, Shanghai, China. 3. Taishan Medical University, Shandong, China. 4. Department of Orthopaedic, People's Hospital of Shanghai Pudong New Area, Shanghai, China. 5. Department of Orthopaedic, People's Hospital of Cixi, Zhejiang, China. 6. Department of Orthopaedic Oncology Center, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: czyyltl_spine@163.com.
Abstract
BACKGROUND: Reconstruction of thoracolumbar structural stability is a formidable challenge for spine surgeons after vertebral body tumor resection. Various disadvantages of the currently used expandable or nonexpandable cages have limited their clinical applications. We sought to develop a novel prosthesis for clinical use and assess its preliminary clinical outcome in reconstruction of thoracolumbar structural stability after spinal tumor resection. METHODS: Using data obtained from a retrospective analysis of the morphological characteristics of the thoracolumbar vertebrae and endplates in previously reported studies, we modified the nano-hydroxyapatite/polyamide-66 (n-HA/PA66) strut into a novel height-adjustable vertebral body. A retrospective study was performed of 7 patients who had undergone reconstruction of thoracolumbar structural stability with this novel prosthesis from August 2016 to January 2017. RESULTS: A novel height-adjustable vertebral body (AHVB) composed of n-HA/PA66 with 2 separate components with a 163° contact surface at each end was manufactured. The height-adjustable range was 28-37 mm. No significant implant-related complications were observed in the process of operation. All patients experienced a significant reduction in pain, with the visual analog scale score decreasing from 7.9 to 4.0. Neurological improvement was assessed using the Frankel grading system after surgery. Postoperative radiographic and computed tomography/magnetic resonance imaging findings indicated that the operated segment was stable, the outcome of kyphosis correction was good, and no prosthesis subsidence or dislocation was observed. CONCLUSION: This novel prosthesis has many advantages in the reconstruction of height, lordosis, and alignment after thoracolumbar spinal tumor resection and has a favorable prospect for clinical application.
BACKGROUND: Reconstruction of thoracolumbar structural stability is a formidable challenge for spine surgeons after vertebral body tumor resection. Various disadvantages of the currently used expandable or nonexpandable cages have limited their clinical applications. We sought to develop a novel prosthesis for clinical use and assess its preliminary clinical outcome in reconstruction of thoracolumbar structural stability after spinal tumor resection. METHODS: Using data obtained from a retrospective analysis of the morphological characteristics of the thoracolumbar vertebrae and endplates in previously reported studies, we modified the nano-hydroxyapatite/polyamide-66 (n-HA/PA66) strut into a novel height-adjustable vertebral body. A retrospective study was performed of 7 patients who had undergone reconstruction of thoracolumbar structural stability with this novel prosthesis from August 2016 to January 2017. RESULTS: A novel height-adjustable vertebral body (AHVB) composed of n-HA/PA66 with 2 separate components with a 163° contact surface at each end was manufactured. The height-adjustable range was 28-37 mm. No significant implant-related complications were observed in the process of operation. All patients experienced a significant reduction in pain, with the visual analog scale score decreasing from 7.9 to 4.0. Neurological improvement was assessed using the Frankel grading system after surgery. Postoperative radiographic and computed tomography/magnetic resonance imaging findings indicated that the operated segment was stable, the outcome of kyphosis correction was good, and no prosthesis subsidence or dislocation was observed. CONCLUSION: This novel prosthesis has many advantages in the reconstruction of height, lordosis, and alignment after thoracolumbar spinal tumor resection and has a favorable prospect for clinical application.