Niu Chi-Chien, Chen Lih-Huei, Lai Po-Liang, Fu Tsai-Sheng, Chen Wen-Jer
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital. 5, Fushing Street, Gueishan Shiang, Taoyuan, Taiwan 333, ROC.
Chang Gung Med J. 2005 Apr;28(4):212-21.
Use of autogenous bone grafting taken from anterior iliac crest for anterior cervical interbody fusion has been the "gold-standard" for decades. Substitutes for autogenous bone graft continue to be sought to avoid potential donor site morbidity. A titanium-alloy square-shaped hollow cage was applied to facilitate the process of fusion as a bone graft substitute, then assessed in this retrospective clinical study.
From July 2000 to July 2001, sixty-three discs from fifty-four patients were selected to receive this cage for one or two segments of the cervical spine for anterior cervical interbody fusion. The Japanese Orthopedic Association (JOA) score and Odom's criteria were used to measure the clinical outcome. Postoperative radiographs were analyzed for graft dislodgement, loss of anterior and posterior disc heights, maintenance of lordosis correction, and status of fusion between the cage and endplates to assess their suitability as a grafting substitute.
Eighty-seven percent of patients exhibited satisfactory clinical outcome. Successful fusion was obtained in ninety point five percent of operated discs. Partial cage dislodgement was observed in four point eight percent of discs and caused no adverse symptoms. The mean collapse of the anterior and posterior disc heights were 1.73 mm and 0.91 mm, respectively. Moreover, the mean loss of lordosis correction was 2.75 degrees.
Based on this primary clinical experience, the trapezoid-design, titanium-alloy cage provided adequate mechanical support and stability in the disc space and an excellent fusion result without significant subsidence of disc height or any other complications.
几十年来，取自髂前嵴的自体骨移植用于颈椎前路椎体间融合一直是“金标准”。人们一直在寻找自体骨移植的替代品，以避免潜在的供区并发症。一种钛合金方形中空椎间融合器作为骨移植替代品被应用于促进融合过程，并在这项回顾性临床研究中进行评估。
从2000年7月至2001年7月，选取54例患者的63个椎间盘接受该椎间融合器，用于颈椎前路椎体间融合的一个或两个节段。采用日本骨科协会（JOA）评分和奥多姆标准来衡量临床疗效。对术后X线片进行分析，以评估植骨移位、椎间盘前后高度丢失、前凸矫正的维持情况以及椎间融合器与终板之间的融合状态，从而评估其作为移植替代品的适用性。
87%的患者临床疗效满意。90.5%的手术椎间盘获得了成功融合。4.8%的椎间盘观察到部分椎间融合器移位，但未引起不良症状。椎间盘前后高度的平均塌陷分别为1.73毫米和0.91毫米。此外，前凸矫正的平均丢失为2.75度。
基于这一初步临床经验，梯形设计的钛合金椎间融合器在椎间盘间隙提供了足够的机械支撑和稳定性，融合效果良好，椎间盘高度无明显下沉或其他并发症。
