Kast Erich, Derakhshani Sharam, Bothmann Matthias, Oberle Joachim
Department of Neurosurgery, Kantonsspital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Switzerland.
Neurosurg Rev. 2009 Apr;32(2):207-14; discussion 214. doi: 10.1007/s10143-008-0168-y. Epub 2008 Sep 17.
In ventral fusion after anterior cervical discectomy there is still a remarkable number of cage subsidence and segmental kyphosis seen. The aim of the present study is to assess whether the cage design influences the extent of correction loss during follow-up. Sixty patients with single-level cervical disc herniation were randomly treated with two different cervical inter-body cages (group 1: Solis cage, Stryker Company and group 2: Shell cage, AMT Company). Clinical and radiological follow-up was done before and after surgery, 3 and 6 months post-surgery. Clinical follow-up was done with the help of Odom's criteria. Both groups were similar in the baseline parameters (age, sex, treated level). Statistically, the subsidence was significantly higher at 3 and 6-month follow-ups in group 1 than in group 2, however, clinical results showed no significant differences. In 67%, subsidence was seen in the anterior lower aspect of the treated segment. Segmental kyphosis was seen in seven patients of group 1 and two patients of group 2. A significant correlation is found between Odom's criteria and subsidence. Although there was no significant difference in a short-term clinical result between the two treatment groups, we recommend the use of cages which preserve the determined segmental height and lordosis.
在颈椎前路椎间盘切除术后的前路融合术中，仍可观察到相当数量的椎间融合器下沉和节段性后凸。本研究的目的是评估椎间融合器的设计是否会影响随访期间矫正丢失的程度。60名单节段颈椎间盘突出症患者被随机采用两种不同的颈椎椎间融合器进行治疗（第1组：Solis椎间融合器，史赛克公司；第2组：Shell椎间融合器，AMT公司）。在手术前后、术后3个月和6个月进行临床和影像学随访。临床随访借助奥多姆标准进行。两组在基线参数（年龄、性别、治疗节段）方面相似。统计学上，第1组在术后3个月和6个月随访时的下沉明显高于第2组，然而，临床结果显示无显著差异。在67%的病例中，在治疗节段的前下方观察到下沉。第1组有7例患者出现节段性后凸，第2组有2例患者出现节段性后凸。发现奥多姆标准与下沉之间存在显著相关性。尽管两个治疗组的短期临床结果无显著差异，但我们建议使用能保持确定节段高度和前凸的椎间融合器。
