Preparation of Nano Hydroxyapatite/Polyamide Composite and Its Application in Lumbar Disc Herniation Operation

2021 ◽  
Vol 13 (2) ◽  
pp. 245-253
Author(s):  
Yue Wang ◽  
Priyadarshi M. S. Harsh ◽  
Liyong Wu ◽  
Hengmei Chen ◽  
Chengzhao Liu ◽  
...  

Carbon fiber (CFR) was used to strengthen the mechanical properties of hydroxyapatite/polyamide (ha/pa) to synthesize ternary composites with different mass fraction. At the same time, its mechanical and material characterization were compared with that of ha/pa without CFR. CFR-ha/pa was used as the substrate for the culture of mouse bone marrow mesenchymal stem cells (C3H10T1/2). The cell morphology and adhesion properties of materials were analyzed by immuno light staining of cytoskeleton and adhesion protein, and FESEM. The interbody fusion cage based on the material was used in the treatment of lumbar disc herniation. According to the X-ray film and the corresponding scoring standards (JOA, ODI and VAS), the therapeutic effect of the interbody fusion cage was evaluated. The results showed that there were cavities on the surface of CFR-ha/pa composites. With the increase of the mass fraction of CFR in CFR-ha/pa composites, the compressive strength (from 115 MPa to 218 Mpa), the bending strength (from 85 MPa to 140 MPa) and other mechanical indexes of the composite increased obviously. After 24 h of cell inoculation, the substrate of CFR-ha/pa group was covered by layered, well spread and fused cells, and there was dense cell adhesion around it, that was to say, the material and cells showed good adhesion performance. At the same time, the levels of Integrin α1 and Integrin β1 significantly increased in CFR-ha/pa group (P < 0.05). The VAS and ODI scores of polyether ether ketone (Peek) interbody fusion cage group and CFR-ha/pa interbody fusion cage group were lower than those before operation (P < 0.05). The therapeutic effect of CFR-ha/pa interbody fusion cage is better than Peek interbody fusion cage.

2021 ◽  
Vol 18 (2) ◽  
pp. 34-43
Author(s):  
M. N. Kravtsov ◽  
I. A. Kruglov ◽  
S. D. Mirzametov ◽  
A. S. Seleznev ◽  
N. P. Alekseyeva ◽  
...  

Objective. To compare the effectiveness of surgical methods for treating patients with recurrent lumbar disc herniation.Material and Methods. The sample consisted of 160 patients operated on in 2014–2019 for recurrent lumbar disc herniation by percutaneous endoscopic discectomy (Group 1), microsurgical discectomy (Group 2), single-level transforaminal interbody fusion (Group 3) and single-level total intervertebral disc replacement (Group 4). The effectiveness of surgical treatment was evaluated using the NRS-11, ODI, and MacNab questionnaires.Results. Assessment of the pain syndrome severity and the vital activity level of patients revealed significant (p < 0.05) differences in favor of total intervertebral disc replacement. Excellent and good outcomes after arthroplasty according to MacNab criteria were noted in all patients in this group. Similar outcomes were reported in 77.5 % (31/40) of patients in the TLIF group, in 75.1 % (24/32) of patients in the percutaneous endoscopic discectomy group and in 72.6 % (45/62) of patients in the microdiscectomy group. The operation time and length of hospital stay were shorter in the endoscopic and microsurgical discectomy groups (p < 0.001). However, the lower incidence of complications and reoperations was observed in groups of posterior interbody fusion and arthroplasty (p > 0.05).Conclusion. Arthroplasty with the M6-L implant expands the possibilities of surgery for recurrent lumbar disc herniation. Total intervertebral disc replacement and posterior interbody fusion for recurrent lumbar disc herniation are more effective in comparison with decompressive operations, which is reflected in the improvement of clinical treatment outcomes, reduction of perioperative complications and frequency of repeated interventions.


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