Application of Hydroxyapatite Artificial Bone in Bilateral open-door Posterior Cervical Expansive Laminoplasty
摘要
BACKGROUND: Hydroxyapatite (HA) artificial bone, as bone grafting substitute, would not cause inflammatory reaction or mmunological rejection and possesses good biocompatibility after transplantation into human body. It is a novel implant material with bone conduction ability. OBJECTIVE: To investigate the efficacy of HA artificial bone in bilateral open-door posterior cervical expansive laminoplasty and to make a comparison with autogenous bone. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Spine Surgery, Hungpuyuan Branch, the First Affiliated Hospital of Sun Yat-sen University from March 2001 to December 2008. PARTICIPANTS: Seventy patients with cervical spondylosis complicated by compression in 3 or more segments or by cervical stenosis and additional fifteen patients with cervical stenosis complicated by cervical trauma were included in this study. METHODS: A bilateral open-door posterior cervical expansive laminoplasty was performed, in which, 23 patients received autogenous bone transplantation (autogenous bone group) and 62 patients underwent HA artificial bone transplantation (HA group). MAIN OUTCOME MEASURES: ① Japanese Orthopaedic Association (JOA) score prior to and after surgery, surgery time, and intraoperative bleeding. ② HA artificial bone-host biocompatibility. RESULTS: All eighty-five patients were followed up for more than 3 months. There was no significant difference in JOA scores no matter prior to or after surgery between the autogenous bone and HA groups (P＞0.05). The surgery time averaged 85.2 minutes (range 65 110 minutes) in the HA group and averaged 116.4 minutes (range 75 150 minutes) in the autogenous bone group. The intraoperative bleeding averaged 210 mL (range 130-400 mL) in the HA group and averaged 260 mL (range 170500 mL) in the autogenous bone group. There were no material-host response and other severe complications found in each group, except HA artificial bone fragmentation in