Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.
Acta Neurochir (Wien). 2011 Jan;153(1):115-22. doi: 10.1007/s00701-010-0821-4. Epub 2010 Oct 6.
Anterior cervical decompression and fusion (ACDF) is a widely accepted surgical procedure for the treatment of cervical degenerative disc diseases. This retrospective study was designed to analyze and compare the efficacy and outcomes of anterior cervical fusion using stand-alone polyetheretherketone (PEEK) cages and autogenous iliac crest grafts with the anterior cervical plating system.
A total of 72 consecutive patients suffering from cervical degenerative disc diseases treated with ACDF from June 2005 to Dec 2008 were enrolled in the study. Patients in group A (40 patients, 64 segments) had anterior interbody fusion with stand-alone PEEK cages and patients in group B (32 patients, 51 segments) with autogenous iliac crest graft combined with anterior plate fixation. The operative time and intraoperative blood loss were recorded. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scoring system; cervical lordosis, intervertebral height, and cervical fusion status were assessed on X-ray and computed tomography.
The mean follow-up period was 17.3 months in the stand-alone cage group and 23.2 months in the autologous iliac crest graft group. The operative time and intraoperative blood loss in group A were much less than those in group B (p < 0.05). All the patients in both groups got complete interbody fusion. Postoperative JOA scores in both group A and group B were more than the preoperative ones with significant differences, and the improvement rate of JOA scores had no statistical differences between group A and group B. Postoperative cervical physiological curvature and intervertebral height in both groups were better than the preoperative ones with statistical significances.
The stand-alone PEEK cage is a good substitute for fusion in patients with cervical disc disease; it can effectively restore the cervical physiological curvature and the intervertebral height, facilitate radiological follow-up, cause few complications, and leads to satisfactory outcomes.
颈椎前路减压融合术（ACDF）是治疗颈椎退行性椎间盘疾病的一种广泛接受的手术方法。本回顾性研究旨在分析和比较使用独立聚醚醚酮（PEEK）笼和自体髂嵴移植物与颈椎前路板系统进行颈椎前路融合的疗效和结果。
2005 年 6 月至 2008 年 12 月，共纳入 72 例因颈椎退行性椎间盘疾病接受 ACDF 治疗的连续患者。A 组（40 例，64 个节段）患者采用独立 PEEK 笼行前路椎间融合，B 组（32 例，51 个节段）患者采用自体髂嵴移植联合前路板固定。记录手术时间和术中失血量。采用日本矫形协会（JOA）评分系统评估临床结果；X 线和 CT 评估颈椎曲度、椎间高度和颈椎融合情况。
独立笼组的平均随访时间为 17.3 个月，自体髂嵴移植组为 23.2 个月。A 组的手术时间和术中失血量明显少于 B 组（p<0.05）。两组患者均获得完全椎间融合。两组术后 JOA 评分均高于术前，差异有统计学意义，两组间 JOA 评分改善率无统计学差异。两组术后颈椎生理曲度和椎间高度均优于术前，差异有统计学意义。
独立 PEEK 笼是颈椎间盘疾病患者融合的良好替代物；它可以有效恢复颈椎生理曲度和椎间高度，便于影像学随访，并发症少，结果满意。
