Long-term results of anterior cervical corpectomy and fusion with nano-hydroxyapatite/polyamide 66 strut for cervical spondylotic myelopathy

Abstract

To assess the long-term clinical and radiographic outcomes of anterior cervical corpectomy and fusion (ACCF) with a neotype nano-hydroxyapatite/polyamide 66 (n-HA/PA66) strut in the treatment of cervical spondylotic myelopathy (CSM). Fifty patients with CSM who underwent 1- or 2-level ACCF with n-HA/PA66 struts were retrospectively investigated. With a mean follow-up of 79.6 months, the overall mean JOA score, VAS and cervical alignment were improved significantly. At last follow-up, the fusion rate was 98%, and the subsidence rate of the n-HA/PA66 strut was 8%. The “radiolucent gap” at the interface between the n-HA/PA66 strut and the vertebra was further noted to evaluate the osteoconductivity and osseointegration of the strut, and the incidence of it was 62% at the last follow-up. Three patients suffered symptomatic adjacent segment degeneration (ASD). No significant difference was detected in the outcomes between 1- and 2-level corpectomy at follow-ups. In conclusion, the satisfactory outcomes in this study indicated that the n-HA/PA66 strut was an effective graft for cervical reconstruction. Moreover, the osteoconductivity and osseointegration of the strut is still need to be optimized for future clinical application owing to the notably presence of “radiolucent gap” in present study.

Polydopamine-induced hydroxyapatite coating facilitates hydroxyapatite/polyamide 66 implant osteogenesis: an in vitro and in vivo evaluation

“…The supernatant was collected (5 mL) after 1, 4, and 7 days, and the same volume of fresh normal saline was added to the polypropylene vial. The concentration of Ca and PO 4 3− ions in the collected supernatant was analyzed by inductively coupled plasma optical emission spectrometer (ICP-OES; iCAP 6300; Thermo Fisher Scientific, Waltham, MA, USA).…”

“…The cells were seeded in each well at a density of 2×10 4 , cocultured for 24 hours, and examined by SEM and confocal laser scanning microscopy (CLSM) to observe cell spreading. SEM was employed to visualize the cytoskeleton.…”

“…Different sized samples were placed into six-well (for 28 × 20 × 2 mm samples) or 24-well (for Φ10 mm samples) plates for Western blotting, ALP activity assay, and alizarin red staining. Then, the C3H10T1/2 cells were seeded at a density of 5×10 4 cells/well for the six-well plates and 2×10 4 cocultivation, the DMEM/F12 culture medium was replaced with osteogenic induction medium (Cyagen Biosciences Co., Ltd., Guangzhou, People's Republic of China); the latter was replaced every 3 days.…”

“…Our group has carried out considerable basic research and clinical studies in this field. [4][5][6][7][8] We found that the amount of HA particles deposited on the surface of HA/P66 was relatively low, which affected the rate and quality of the initial osseointegration in HA/P66 implants. Different methods were employed to modify HA/P66 implants to promote osseointegration.…”

Progress of titanium strut for cervical reconstruction with nano-graphene oxide loaded hydroxyapatite/polyamide composite and interbody fusion after corpectomy with anterior plate fixation

“…The surgical therapies of the cervical corpectomy and fusion are exceedingly mutable including different approaches such as methods of anterior, posterior and including combination treatment of anterior-posterior and posterior-anterior strategies [1][2][3]. Among these fixation approaches, only the anterior method is recommended for the close/open reduction, instrumental fusion, discectomy and specifically for intervertebral disc herniation [4,5].…”