Clinical Use of a New Nano-Hydroxyapatite/Polyamide66 Composite Artificial Lamina in Spinal Decompression Surgery: More Than 4 Years’ Follow-Up

Abstract

BackgroundLong-term follow-up results showed that epidural scar formation and adhesion after laminectomy always affected the outcomes of repeat operations. The establishment of a barrier between scar tissue and dura was effective in preventing epidural scar formation.Material/MethodsA nano-hydroxyapatite/polyamide66 (n-HA/PA66) artificial lamina was designed and fabricated and used to cover the opened spinal canal in patients who received laminectomy. The visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) Scores, X-ray, computed tomography, and magnetic resonance imaging results were periodically recorded and evaluated.ResultsAll patients were followed up for 4–7 years, with an average period of 5.2 years. The clinical symptoms improved significantly after surgery, as the JOA scores were significantly improved after the operation and maintained to last follow-up when compared with preoperative ones (P<0.05). The vertebral canal became noticeably enlarged, from 16.7±4.7 mm to 32.9±2.2 mm, after surgery and well maintained to 32.1±1.8 mm. The lumbar lordosis was well maintained after surgery. No rupture, absorption, or dislodgement of the n-HA/PA66 lamina was found. MRI showed the spinal canal had the correct morphology, with no stenosis, no obvious scar formation, and no nerve roots or epidural sac compression.ConclusionsThe artificial lamina is a reasonable choice for prevention of epidural scar formation after laminectomy, in spite of the results from a small sample of cases.

Biomechanical effects of reconstruction of the posterior structures after laminectomy with an individualized poly-ether-ether-ketone (PEEK) artificial lamina

“…2 An artificial lamina is a kind of biomimetic implant synthesized with biomaterials that can stabilize the lumbar spine and prevent the formation of an epidural scar by reconstructing the lamina structure after laminectomy. [3][4][5][6] However, these regularly shaped artificial laminae have difficulty matching the complex surface of the lumbar lamina and thus may affect their biological and biomechanical functions.…”

Nomogram for predicting the unfavourable outcomes of percutaneous endoscopic transforaminal discectomy for lumbar disc herniation: a retrospective study

“…Further, partial removal of PC may affect the stability of the posterior tissues of the intervertebral disc, and form new fissures and tears postoperatively, which leads to recurrent LDH. Moreover, the removal of PC requires a dynamic bur, which greatly damages the normal structure of the spinal canal and may cause epidural adhesion and fibrosis, leading to postoperative pain (37). We believe that the key to PETD for LDH is the decompression of the nerve root.…”

Artificial lamina after laminectomy: Progress, applications, and future perspectives

“…This artificial lamina normally consists of the inorganic element, which provides mechanical support, and the organic element, which prevents scar tissue formation. Zhao et al ( 47 ). designed and fabricated a novel composite artificial lamina made of nano-hydroxyapatite/polyamide66 (n-HA/PA66) in spinal decompression surgery.…”

“…Front view ( A ); preoperative CT images showing lumbar disc herniation compressing the nerve root on the right side ( B ). The postoperative CT and radiographs films show good internal fixation with good spinal alignment ( C–E ) ( 47 ).…”