Clinical Outcomes of Posterior Surgery with Autologous Lamina Spinous Process Bone and Nanohydroxyapatite/Polyamide-66 for Single-Segment Lumbar Tuberculosis

Objective To evaluate the key techniques and benefits of autologous lamina spinous process (LSP) bone with nanohydroxyapatite/polyamide-66 (n-HA/PA66) in single-segment lumbar tuberculosis posterior surgery Methods This retrospective study analyzed 39 patients with single-segment lumbar tuberculosis. They were treated at our department from January 2018 to December 2023. Based on the graft material, patients were assigned to one of two groups: Group A (n = 19) received a composite bone graft (LSP + n-HA/PA66), while Group B (n = 20) underwent a traditional autologous iliac bone graft. Surgical parameters, including operative time and blood loss. Clinical outcomes were assessed using the visual analogue scale (VAS) and Oswestry Disability Index (ODI). Inflammatory markers were evaluated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Neurological status was graded with the American Spinal Injury Association (ASIA) grade. Radiographic investigation involved measuring the Cobb angle at three time points and checking if the bones had fused. Results All patients were followed up for an average of 19.59 ± 1.53 months. Group A had a shorter surgery time and less blood loss during surgery. These differences were statistically significant. (P < 0.05). Both groups exhibited significant postoperative improvements in ESR, CRP, ODI, and VAS scores at all time points compared to their preoperative baselines (P < 0.05). Neurological function improved in the majority of patients postoperatively. and no significant difference was found in ASIA grades at the final follow-up (P > 0.05). All patients achieved bone fusion. However, Group A needed more time to reach fusion than Group B. This difference was statistically significant (P < 0.05). Regarding complications, one elderly patient in Group A developed muscular venous thrombosis in the right lower limb. In Group B, five patients (25%) experienced persistent pain at the iliac crest graft site. The incidence of donor site pain was significantly higher in Group B (P < 0.05). Conclusions For single-segment lumbar tuberculosis, a composite bone graft (LSP + n-HA/PA66) represents a promising grafting method. Compared to traditional autologous iliac bone, this composite graft reduces operative time and blood loss while eliminating donor site morbidity.