Finiels P J
Unité de Neurochirurgie et Pathologie Rachidienne, Polyclinique Chirurgicale Kennedy, avenue Kennedy, 30900 Nîmes, France.
Neurochirurgie. 2004 Dec;50(6):630-8. doi: 10.1016/s0028-3770(04)98454-8.
The aim of this work was to study the behavior of porous alumina ceramic cages in spinal cervical surgery, with or without plate fixation as needed.
The population included 61 patients who underwent spinal surgery between May 1999 and October 2003. There were 48 women and 13 men, mean age 49 years at surgery. 74 implants were used, among them 71 were interbody cages. Ten patients were operated at two levels; C5-C6 and C6-C7 were most frequently instrumented. Patients were reviewed at 1 month, 3 months and 6 months, and, whenever possible more after. Clinical and radiological data were available for all patients.
Mean follow-up was 7.2 months. Postoperative clinical data included assessment of neck and arm pain, using a visual analogic scale and fusion status determined by the presence of trabecular bridging bone and the disappearance of lucent lines around the implant on plain anteroposterior and lateral cervical radiographs. Two patients required another intervention, allowing intra-operative assessment of the quality of fusion. Clinical results were in agreement with the usual outcome reported in the literature with 54% of patients free of postoperative neck or arm pain and restriction of function mild or absent in 88%. Bone healing was achieved at 6 months on the average in 58 cases and in all patients at 12 months, including the two patients who required revision.
The porous alumine cage is a reliable biocompatible and mechanically stable element helpful for achieving bone healing. Integration into bone tissue was radiographically satisfactory. This kind of implant appears to be an attractive alternative in spinal cervical surgery, avoiding donor graft site complications.
本研究旨在探讨多孔氧化铝陶瓷椎间融合器在颈椎手术中的应用情况，手术中根据需要决定是否使用钢板固定。
研究对象为1999年5月至2003年10月期间接受脊柱手术的61例患者。其中女性48例，男性13例，手术时平均年龄49岁。共使用了74枚植入物，其中71枚为椎间融合器。10例患者接受了两个节段的手术；最常进行手术的节段是C5-C6和C6-C7。分别在术后1个月、3个月和6个月对患者进行复查，如有可能，还会进行更长期的随访。所有患者均有临床和影像学资料。
平均随访时间为7.2个月。术后临床资料包括采用视觉模拟评分法评估颈部和手臂疼痛情况，以及通过颈椎正侧位X线片上植入物周围小梁骨桥接的出现和透亮线的消失来确定融合状态。2例患者需要再次手术，以便在术中评估融合质量。临床结果与文献报道的常见结果一致，54%的患者术后颈部或手臂无痛，88%的患者功能受限轻微或无功能受限。平均58例患者在6个月时实现了骨愈合，所有患者在12个月时均实现了骨愈合，包括2例需要翻修的患者。
多孔氧化铝椎间融合器是一种可靠的生物相容性好且机械稳定性高的元件，有助于实现骨愈合。在影像学上，其与骨组织的融合情况令人满意。这种植入物似乎是颈椎手术中一种有吸引力的选择，可避免供体骨移植部位的并发症。
