Applied nano-hydroxyapatite/polyamide 66 strut in anterior reconstructive surgery for lumbar spinal tuberculosis： a comparison with autogenous iliac bone graft.

Abstract

This study aimed to compare the clinical efficacy of nano-hydroxyapatite/polyamide 66 strut （n-HA/PA66 group） with autogenous iliac bone grafts（AIBG group） in anterior reconstructive surgery for lumbar spinal tuberculosis（LSTB）. A total of 67 patients with LSTB who underwent one-stage combined anterior-posterior surgery using an n-HA/PA66 strut or an autogenous iliac bone graft were studied retrospectively at a mean follow-up of 33.8±7.0 months. The Data about erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Orthopaedic Association (JOA) and Oswestry Disability Index (ODI)score, visual analog scale (VAS) score, American Spinal Injury Association（ASIA ）grade, and Cobb's angle were recorded and compared between the two groups before surgery, three months after surgery and at the last follow-up. At the last follow-up, both groups achieved satisfactory bony fusion without recurrence of tuberculosis, while ESR, CRP, VAS, ASIA grade, and Cobb angle were significantly improved at the last follow-up compared to the preoperative. The n-HA/PA66 group was superior in operation time(P < 0.05), intraoperative blood loss (P < 0.05), VAS at 3 months after surgery (P < 0.05), and surgical complications as compared with the AIBG group. But the bone fusion time of the n-HA/PA66 group (8.4±1.3 months) was slightly longer than the TMC group (7.5±1.6 months)( P < 0.05). The nano-hydroxyapatite/polyamide 66 strut can achieve good clinical efficacy comparable to autologous iliac bone grafts when treating tuberculosis of the lumbar spine. The less traumatic， lower incidence of complications， and similar excellent bony fusion indicated it could serve as a superior material in the anterior reconstructive surgery for lumbar spinal tuberculosis.