Kroppenstedt Stefan, Gulde Martin, Schönmayr Robert
Universitätsklinikum Charité-Campus Virchow-Klinikum, Augustenburger Platz, Berlin, Germany.
Spine (Phila Pa 1976). 2008 Sep 1;33(19):2083-8. doi: 10.1097/BRS.0b013e31818448a9.
A retrospective clinical study with a follow-up of more than 7 years was conducted.
To compare interbody fusion, segmental lordosis and changes in disc and foramen height in patients who had received instrumented posterior lumbar interbody fusion (PLIF) with 1 or 2 closed-box titanium cages.
PLIF using 2 cages is a popular surgical method for treating degenerative lumbar spinal diseases. Implantation of a single cage in instrumented PLIF is still controversial.
From 1994 to 1997, 46 patients with degenerative lumbar spinal disease underwent single-level instrumented PLIF surgery using 1 (n = 22) or 2 (n = 24) interbody rectangular-shaped titanium blocks coated with Plasmapore (Prospace, B. Braun Aesculap AG, Tuttlingen). Mean follow-up was 8 years, ranging from 7 to 10 years. Anteroposterior and lateral radiographs of the patients were taken immediately after surgery and at the last follow-up examination. Segmental stability, change in segmental height, foramen height, and segmental lordosis were evaluated in both groups.
Eight years after surgery, segmental stability (1-cage: 95.5%; 2 cages: 95.8%; P > 0.05), change in segmental height (1-cage: -1.9% +/- 3.7%; 2-cage: -2.4% +/- 3.6%; P > 0.05), foramen height (1-cage: -3.7% +/- 9.9%; 2-cage: -6.6% +/- 6.5%; P > 0.05) and segmental lordosis (1-cage: -2.4 degrees +/- 4.8; 2-cage -1.0 degrees +/- 4.0; P > 0.05) did not differ significantly between the 2 groups. Due to adjacent segment syndrome, 3 patients with a previous 2-cage PLIF received additional fusion surgery.
In the long-term, instrumented PLIF with a single closed-box titanium cage shows similar radiologic results compared to fusion with 2 titanium cages. Implantation of a single titanium closed-box cage in an instrumented PLIF seems to be adequate in case of degenerative lumbar spinal disease.
开展了一项随访超过7年的回顾性临床研究。
比较接受1个或2个封闭盒式钛笼的器械辅助后路腰椎椎间融合术（PLIF）患者的椎间融合、节段性前凸以及椎间盘和椎间孔高度的变化。
使用2个椎间融合器的PLIF是治疗退行性腰椎疾病的一种常用手术方法。在器械辅助PLIF中植入单个椎间融合器仍存在争议。
1994年至1997年，46例退行性腰椎疾病患者接受了单节段器械辅助PLIF手术，使用1个（n = 22）或2个（n = 24）涂有Plasmapore的矩形椎间钛块（Prospace，贝朗蛇牌股份公司，图特林根）。平均随访时间为8年，范围为7至10年。术后即刻及末次随访时拍摄患者的前后位和侧位X线片。评估两组的节段稳定性、节段高度变化、椎间孔高度和节段性前凸。
术后8年，两组在节段稳定性（1个椎间融合器：95.5%；2个椎间融合器：95.8%；P > 0.05）、节段高度变化（1个椎间融合器：-1.9%±3.7%；2个椎间融合器：-2.4%±3.6%；P > 0.05）、椎间孔高度（1个椎间融合器：-3.7%±9.9%；2个椎间融合器：-6.6%±6.5%；P > 0.05）和节段性前凸（1个椎间融合器：-2.4°±4.8；2个椎间融合器：-1.0°±4.0；P > 0.05）方面无显著差异。由于相邻节段综合征，3例曾接受2个椎间融合器PLIF手术的患者接受了额外的融合手术。
长期来看，与使用2个钛笼融合相比，使用单个封闭盒式钛笼的器械辅助PLIF显示出相似的影像学结果。在退行性腰椎疾病的情况下，在器械辅助PLIF中植入单个钛封闭盒式椎间融合器似乎是足够的。
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