BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANGBo ,  OUYunsheng , JIANGDianming , WANGXiaofeng , YANGDongjun

Department of Orthopaedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding?author：

OUYunsheng, Email: ouyunsheng2001@163.com

Keywords：

Nano-hydroxyapatite/polyamide 66; Cage; Transforaminal lumbar interbody fusion; Biomechanics; Porcine

DOI：

10.7507/1002-1892.20150160

Video：

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Objective To compare the biomechanical differences between the kidney-shaped nano-hydroxyapatite/polyamide 66 (n-HA/PA66) Cage and the bullet-shaped n-HA/PA66 Cage. Methods L₂-L₅ spinal specimens were selected from 10 adult male pigs. L₂, L₃ and L₄, L₅ served as a motor unit respectively, 20 motor units altogether. They were divided into 4 groups (n=5):no treatment was given as control group (group A); nucleus pulposus resection was performed (group B); bullet-shaped Cage (group C), and kidney-shaped Cage (group D) were used in transforaminal lumbar interbody fusion (TLIF) through left intervertebral foramen and supplemented by posterior pedicle screw fixation. The intervertebral height (IH) and the position of Cages were observed on the X-ray films. The range of motion (ROM) was measured. Results There was no significant difference in the preoperative IH among 4 groups (F=0.166, P=0.917). No significant change was found in IH between at pre- and post-operation in group B (P>0.05); it increased after operation in groups C and D, but difference was not statistically significant (P>0.05). There was no significant difference in the postoperative IH among groups B, C, and D (P>0.05). The distance from Cage to the left margin was (3.06±0.51) mm in group C (close to the left) and (5.68±0.69) mm in group D (close to the middle), showing significant difference (t=6.787, P=0.000). The ROM in all directions were significantly lower in groups C and D than in groups A and B (P<0.05), and in group A than in group B (P<0.05). The right bending and compression ROM of group C were significantly higher than those of group D (P<0.05), but no statistically significant difference was found in the other direction ROM (P>0.05). Conclusion The bullet-shaped and kidney-shaped Cages have similar results in restoring IH and maintaining the stability of the spine assisted by internal fixation. Kidney-shaped Cage is more stable than bullet-shaped Cage in the axial compression and the bending load opposite implant, it can be placed in the middle and back of the vertebral body more ideally.

Citation： YANGBo, OUYunsheng, JIANGDianming, WANGXiaofeng, YANGDongjun. BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 746-750. doi: 10.7507/1002-1892.20150160 Copy

1.	Yang Meng, Chen Min-fang, Wang Hao, et al. In vitro and in vivo biocomptibility of nano-hydroxyapatite/polymide 66 as bone repair material. 中國組織工程研究與臨床康復, 2010, 14(8):1513-1516.
2.	李鴻, 李玉寶, 嚴永剛, 等. 納米羥基磷灰石/聚酰胺66多孔材料制備和生物安全性初步評價. 生物醫學工程學雜志, 2008, 25(5):1126-1129.
3.	劉顯宏, 歐云生, 蔣電明, 等. n-HA/PA66與PEEK cage在頸前路椎間盤切除減壓術后椎間隙重建的比較研究. 中國臨床解剖學雜志, 2012, 30(6):687-692.
4.	歐云生, 蔣電明, 權正學, 等. 納米羥基磷灰石/聚酰胺66復合生物活性人工椎體在胸腰椎骨折前路重建手術中的應用. 中國修復重建外科雜志, 2007, 21(10):1084-1088.
5.	楊曦, 宋躍明, 孔清泉, 等. 納米羥基磷灰石/聚酰胺66椎間融合器植骨融合治療下腰椎退變性疾病的近期療效. 中國修復重建外科雜志, 2012, 26(12):1425-1429.
6.	Evans JH. Biomechanics of lumbar fusion. Clin Orthop Relat Res, 1985, (193):38-46.
7.	Fukuta S, Miyamoto K, Hosoe H, et al. Kidney-type intervertebral spacers should be located anteriorly in cantilever transforaminal lumbar interbody fusion:analyses of risk factors for spacer subsidence for a minimum of 2 years. J Spinal Disord Tech, 2011, 24(3):189-195.
8.	王曉峰, 歐云生, 蔣電明, 等. 腎型n-HA/PA66腰椎間融合器在經椎間孔腰椎椎體間融合術中的有限元分析. 中國臨床解剖學雜志, 2014, 32(1):67-71.
9.	Dath R, Ebinesan AD, Porter KM, et al. Anatomical measurements of porcine lumbar vertebrae. Clin Biomech (Bristol, Avon), 2007, 22(5):607-613.
10.	陸斌. 前路手術對頸椎穩定性影響的生物力學研究. 西安:第四軍醫大學, 2004.
11.	張振山. 自體骨腰椎椎間融合的生物力學及臨床研究. 廣州:廣州醫學院, 2011.
12.	Yang X, Song Y, Liu L, et al. Anterior reconstruction with nano-hydroxyapatite/polyamide-66 cage after thoracic and lumbar corpectomy. Orthopedics, 2012, 35(1):e66-73.
13.	劉曼, 孟耀, 周立偉, 等. 納米羥基磷灰石/聚酰胺66復合膜的結構及成骨樣細胞相容性研究. 現代口腔醫學雜志, 2012, 26(1):3-7.
14.	Zhao Z, Jiang D, Ou Y, et al. A hollow cylindrical nano-hydroxyapatite/polymide composite strut for cervical reconstruction after cervical corpectomy. J Clin Neurosci, 2012, 19(4):536-540.
15.	Le TV, Baaj AA, Dakwar E, et al. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine (Phila Pa 1976), 2012, 37(14):1268-1273.
16.	Vadapalli S, Robon M, Biyani A, et al. Effect of lumbar interbody cage geometry on construct stability:a cadaveric study. Spine (Phila Pa 1976), 2006, 31(19):2189-2194.
17.	Wang ST, Goel VK, Fu CY, et al. Comparison of two interbody fusion cages for posterior lumbar interbody fusion in a cadaveric model. Int Orthop, 2006, 30(4):299-304.
18.	Hou Y, Luo Z. A Study on the structural properties of the lumbar endplate:histological structure, the effect of bone density, and spinal level. Spine (Phila Pa 1976), 2009, 34(12):E427-E433.

1. Yang Meng, Chen Min-fang, Wang Hao, et al. In vitro and in vivo biocomptibility of nano-hydroxyapatite/polymide 66 as bone repair material. 中國組織工程研究與臨床康復, 2010, 14(8):1513-1516.
2. 李鴻, 李玉寶, 嚴永剛, 等. 納米羥基磷灰石/聚酰胺66多孔材料制備和生物安全性初步評價. 生物醫學工程學雜志, 2008, 25(5):1126-1129.
3. 劉顯宏, 歐云生, 蔣電明, 等. n-HA/PA66與PEEK cage在頸前路椎間盤切除減壓術后椎間隙重建的比較研究. 中國臨床解剖學雜志, 2012, 30(6):687-692.
4. 歐云生, 蔣電明, 權正學, 等. 納米羥基磷灰石/聚酰胺66復合生物活性人工椎體在胸腰椎骨折前路重建手術中的應用. 中國修復重建外科雜志, 2007, 21(10):1084-1088.
5. 楊曦, 宋躍明, 孔清泉, 等. 納米羥基磷灰石/聚酰胺66椎間融合器植骨融合治療下腰椎退變性疾病的近期療效. 中國修復重建外科雜志, 2012, 26(12):1425-1429.
6. Evans JH. Biomechanics of lumbar fusion. Clin Orthop Relat Res, 1985, (193):38-46.
7. Fukuta S, Miyamoto K, Hosoe H, et al. Kidney-type intervertebral spacers should be located anteriorly in cantilever transforaminal lumbar interbody fusion:analyses of risk factors for spacer subsidence for a minimum of 2 years. J Spinal Disord Tech, 2011, 24(3):189-195.
8. 王曉峰, 歐云生, 蔣電明, 等. 腎型n-HA/PA66腰椎間融合器在經椎間孔腰椎椎體間融合術中的有限元分析. 中國臨床解剖學雜志, 2014, 32(1):67-71.
9. Dath R, Ebinesan AD, Porter KM, et al. Anatomical measurements of porcine lumbar vertebrae. Clin Biomech (Bristol, Avon), 2007, 22(5):607-613.
10. 陸斌. 前路手術對頸椎穩定性影響的生物力學研究. 西安:第四軍醫大學, 2004.
11. 張振山. 自體骨腰椎椎間融合的生物力學及臨床研究. 廣州:廣州醫學院, 2011.
12. Yang X, Song Y, Liu L, et al. Anterior reconstruction with nano-hydroxyapatite/polyamide-66 cage after thoracic and lumbar corpectomy. Orthopedics, 2012, 35(1):e66-73.
13. 劉曼, 孟耀, 周立偉, 等. 納米羥基磷灰石/聚酰胺66復合膜的結構及成骨樣細胞相容性研究. 現代口腔醫學雜志, 2012, 26(1):3-7.
14. Zhao Z, Jiang D, Ou Y, et al. A hollow cylindrical nano-hydroxyapatite/polymide composite strut for cervical reconstruction after cervical corpectomy. J Clin Neurosci, 2012, 19(4):536-540.
15. Le TV, Baaj AA, Dakwar E, et al. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine (Phila Pa 1976), 2012, 37(14):1268-1273.
16. Vadapalli S, Robon M, Biyani A, et al. Effect of lumbar interbody cage geometry on construct stability:a cadaveric study. Spine (Phila Pa 1976), 2006, 31(19):2189-2194.
17. Wang ST, Goel VK, Fu CY, et al. Comparison of two interbody fusion cages for posterior lumbar interbody fusion in a cadaveric model. Int Orthop, 2006, 30(4):299-304.
18. Hou Y, Luo Z. A Study on the structural properties of the lumbar endplate:histological structure, the effect of bone density, and spinal level. Spine (Phila Pa 1976), 2009, 34(12):E427-E433.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICAL STUDY ON KIDNEY-SHAPED NANO-HYDROXYAPATITE/POLYAMIDE 66 CAGE

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