The Pain, Life Quality and Low Back Pain Disability of the Patients Who Received Endoscopic Lumbar Intervertebral Fusion With Cages Made of Metal Material Versus Calf Bone: a Real World Study

Background Interbody fusion is a common operation in spinal surgery, which is often used for various causes such as vertebral instability caused by trauma or degeneration. At present, a new material of calf bone interbody fusion cage has been used in clinic, but the curative effect has not been reported yet. In this study, the traditional metal interbody fusion cage was used as the control to evaluate the curative effect of this new type of interbody fusion cage. Method This retrospective non-blind case-control study included 96 patients with lumbar degeneration who underwent single segmental interbody fusion. Among them, 58 cases used calf bone material interbody fusion cage and used metal material (titanium) in 38 cases. The Visual Analogue Score (VAS) and Oswestry Disability Index (ODI) score were compared before, immediately after, 3 months after, 1 year after operation and the last follow-up. IBM SPSS is used to compare the collected data one by one, and the parameter samples are tested by independent-samples t-test. Result There was no significant statistical difference between patients who received calf bone fusion cage and metal fusion cage in each follow-up time point.Conclusion The curative effect of calf bone fusion cage was not inferior to that of traditional metal interbody fusion cage at each follow-up time. Level of Evidence Ⅲ

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

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.

Improvement of Spinopelvic Parameters Following the Surgical Treatment of Spondylolisthesis Using Interbody Fusion Cage

Background: There is no consensus regarding the clinical benefit of interbody fusion cage in the treatment of Spondylolisthesis (SL). This study aimed to evaluate the effect of posterolateral fusion combined with interbody fusion cage on the spinopelvic parameters and the pain level of the patients. Objectives: Role of interbody fusion in the treatment of spondylolisthesis Methods: This prospective study included 40 SL patients who underwent surgery following the failure of conservative management. The Meyerding classification was used to grade SL. Also, the visual analog scale was used to measure the level of pain, before and after the operation. Spinopelvic parameters included total kyphosis, sagittal vertebral axis, pelvic tilt, pelvic incidence, and lumbar lordosis. Results: The Mean±SD age of the patients was of 53.4±11.6 years. In four patients (10%), SL occurred at two levels. Besides, the etiology was degenerative in 21 cases (52.5%) and isthmic in 19 cases (47.5%). The grade I, II, and III of SL were detected respectively in 17, 17, and 6 cases (42.5%, 42.5%, and 15%, respectively). The Mean±SD preoperative value of the sagittal vertebral axis was 43.1±33.1 mm, which improved to 24.8±22.3 mm after the surgery (P<0.001). Also, the Mean±SD preoperative value of the pelvic tilt significantly improved from 19.2±10º to 17±9.1º (P=0.049). Moreover, the Mean±SD score of the visual analog scale improved from 9.1±0.8 to 2.8±1.2 (P<0.001). The clinical and spinopelvic parameters greatly improved in patients with degenerative SLs, single-level SLs, and the lower grades of SL. Conclusion: Posterolateral fusion combined with interbody fusion cage improves both the clinical and spinopelvic parameters of SL patients and could be suggested as the treatment of choice for these patients.