OBJECTIVEThe purpose of this study was to compare the preoperative radiographic features of degenerative lumbar spondylolisthesis (DLS) with and without local coronal imbalance (LCI) and to investigate the surgical outcomes of transforaminal lumbar interbody fusion (TLIF) in the treatment of DLS with LCI at the spondylolisthesis level. DLS with scoliotic disc wedging and/or lateral listhesis at the same involved segment, as well as LCI, constitutes a distinct subgroup. However, previous studies concerning surgical outcomes focused mainly on sagittal profiles. There is a paucity of valid data regarding lumbar coronal alignment and patient-reported outcomes (PROs) after surgery in DLS with LCI.METHODSThe authors reviewed consecutive patients who received TLIF for L4/5 DLS between 2009 and 2018. Patients were assigned to the LCI and non-LCI groups based on preoperative radiographs. Demographics, radiographic parameters related to both sagittal and coronal alignment, and PROs were compared between the 2 groups.RESULTSThere were 21 patients in the LCI and 80 in the non-LCI group. Compared with the non-LCI group, the LCI group was characterized by lower preoperative lumbar lordosis on sagittal alignment (38.3° vs 43.7°, p < 0.05), higher lumbar Cobb angle on coronal alignment (12.4° vs 5.1°, p < 0.05), and worse lumbar coronal balance (18.5 mm vs 6.8 mm, p < 0.05). After surgery, lumbar alignment in the sagittal and coronal planes was significantly improved in the LCI group, whereas no significant changes occurred in the non-LCI group. Scores on the preoperative Oswestry Disability Index and the visual analog scale for back pain and leg pain scores were significantly higher in the LCI group, whereas no differences were found between the 2 groups in the postoperative evaluation (p > 0.05).CONCLUSIONSDLS with LCI constitutes a distinct subgroup characterized by coronal malalignment and loss of whole lumbar lordosis, which may result in worse PROs. The TLIF procedure allows the reconstruction of the coronal and sagittal lumbar profile and achievement of satisfactory PROs.

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Background The aim of this study was to compare the clinical and radiological outcomes of the 3D-printed artificial vertebral body vs the titanium mesh cage in repairing bone defects for single-level anterior cervical corpectomy and fusion (ACCF). Material/Methods A total of 51 consecutive patients who underwent single-level ACCF in Huai’an Second People’s Hospital from July 2017 to August 2020 were retrospectively reviewed. According to the implant materials used, patients were divided into a 3D-printed artificial vertebral body group (3D-printed group) (n=20; 12 males, 8 females) and a titanium mesh cage group (TMC group) (n=31; 15 males, 16 females). General data, radiological parameters, and clinical outcomes were recorded. Results The rate of subsidence in the 3D-printed group (0.01, 2/20) was lower than in the TMC group (0.29, 9/31) ( P <0.05). HAE and HPE of the patients in the 3D-printed group were significantly higher than those in the TMC group ( P <0.05). C2–C7 Cobb angle and SA of the patients in the 3D-printed group were significantly larger than those in the TMC group ( P <0.05). All patients in the 2 groups showed significant improvement in VAS, JOA, and NDI scores at 3 months and 1 year after surgery. Conclusions 3D-printed artificial vertebral body helps maintain intervertebral height and cervical physiological curvature and is a good candidate for ACCF.

Osteoinductivity is a crucial factor to determine the success and efficiency of posterolateral spinal fusion (PLF) by employing calcium phosphate (Ca-P) bioceramics. In this study, three kinds of Ca-P ceramics with microscale to nanoscale gain size (BCP-control, BCP-micro and BCP-nano) were prepared and their physicochemical properties were characterized. BCP-nano had the spherical shape and nanoscale gain size, BCP-micro had the spherical shape and microscale gain size, and BCP-control (BAM®) had the irregular shape and microscale gain size. The obtained BCP-nano with specific nanotopography could well regulate in vitro protein adsorption and osteogenic differentiation of MC3T3 cells. In vivo rabbit PLF procedures further confirmed that nanotopography of BCP-nano might be responsible for the stronger bone regenerative ability comparing with BCP-micro and BCP-control. Collectedly, due to nanocrystal similarity with natural bone apatite, BCP-nano has excellent efficacy in guiding bone regeneration of PLF, and holds great potentials to become an alternative to standard bone grafts for future clinical applications.

Bacterial infection and toxic metal ions releasing are the challenges in the clinical application of Ti6Al4V alloy implant materials. Copper is a kind of long-acting, broad-spectrum and safe antibacterial element, and Ta2O5 has good corrosion resistance, wear-resistance and biocompatibility, they are considered and chosen as a potential coating candidate for implant surface modification. In this paper, magnetron sputtering technology was used to prepare copper doped Ta2O5 multilayer composite coating Cu-Ta2O5/Ta2O5/Ta2O5-TiO2/TiO2/Ti (Cu-MTa2O5 for short) on Ti6Al4V alloy surface, for studying the effect of copper incorporation on the microstructure, wettability, anticorrosion and antibacterial activities of the composite coating. The results showed that Cu-MTa2O5 coating obviously improves the hydrophobicity, corrosion resistance and antibacterial property of Ti6Al4V alloy. In the coating, both copper and Ta2O5 exhibit an amorphous structure and copper mainly presents as an oxidation state (Cu2O and CuO). With the increase of the doping amount of copper, the grain size, roughness, and hydrophobicity of the modified surface of Ti6Al4V alloy are increased. Electrochemical experiment results demonstrated that the corrosion resistance of Cu-MTa2O5 coated Ti6Al4V alloy slightly decreased with the increase of copper concentration, but this coating still acts strong anticorrosion protection for Ti6Al4V alloy. Moreover, the Cu-MTa2O5 coating can kill more than 97% of Staphylococcus aureus in 24 h, and the antibacterial rate increases with the increase of copper content. Therefore, Cu-MTa2O5 composite coating is a good candidate for improving anticorrosion and antibacterial properties of Ti6Al4V alloy implant medical devices.