Landriel Federico A, Hem Santiago, Goldschmidt Ezequiel, Ajler Pablo, Vecchi Eduardo, Carrizo Antonio
Neurosurgical Department, Hospital italiano de Buenos Aires, Argentina.
J Spinal Disord Tech. 2013 Apr;26(2):61-7. doi: 10.1097/BSD.0b013e3182323274.
The aim of this study was to compare the fusion rate, operation time, recovery of disc space height, clinical duration and improvement, return to activities of daily living, and complication rate associated with anterior cervical discectomy with interbody fusion by using polyetheretherketone cages or autogenous iliac crest bone grafts as disc replacement in a series of 60 patients.
Between November 2006 and February 2010 a retrospective analytical observational cohort study was carried out in 60 consecutive patients surgically treated with anterior cervical discectomy with interbody fusion for degenerative disc desease at the Neurosurgical Department of the Hospital Italiano de Buenos Aires. The patients were divided into 2 groups for the assessment of clinical characteristics, demographics, fusion rates, duration of surgical procedure, neurological and functional outcomes, imaging results, and complications. Group A included patients treated with autogenous iliac crest bone grafts, and group B included patients treated with polyetheretherketone cages.
The mean age of the patients was 50.8 years. Female patients comprised the majority in both groups (63.3%). Cervicobrachialgia was the most common presentation. Clinical improvement, fusion rates, and recovery of disc space height were similar in both groups. The operation time was significantly shorter in the polyetheretherketone group (P<0.001). Twenty percent (n=6) of the patients in group A suffered complications, >80% of which were associated with iliac crest bone graft harvesting. Patients in group B had no complications (P<0.05).
Although outcomes were very successful in both groups in terms of fixation stability, recovery of disc space, return to activities of daily living and work, and remission of symptoms, operation time was considerably shorter for patients in the polyetheretherketone group, who had none of the complications associated with iliac crest bone graft harvesting, both differences being statistically significant.
本研究旨在比较60例患者采用聚醚醚酮椎间融合器或自体髂骨植骨进行颈椎前路椎间盘切除椎间融合术时的融合率、手术时间、椎间隙高度恢复情况、临床病程及改善情况、恢复日常生活活动能力以及并发症发生率。
2006年11月至2010年2月，对意大利布宜诺斯艾利斯医院神经外科连续60例因椎间盘退变疾病接受颈椎前路椎间盘切除椎间融合术的患者进行回顾性分析观察队列研究。将患者分为两组以评估临床特征、人口统计学、融合率、手术时间、神经和功能结局、影像学结果及并发症。A组包括接受自体髂骨植骨治疗的患者，B组包括接受聚醚醚酮椎间融合器治疗的患者。
患者的平均年龄为50.8岁。两组中女性患者均占多数（63.3%）。颈臂痛是最常见的表现。两组的临床改善情况、融合率及椎间隙高度恢复情况相似。聚醚醚酮组的手术时间明显更短（P<0.001）。A组20%（n = 6）的患者出现并发症，其中80%以上与髂骨植骨取材有关。B组患者无并发症发生（P<0.05）。
尽管两组在固定稳定性、椎间隙恢复、恢复日常生活活动和工作能力以及症状缓解方面的结果都非常成功，但聚醚醚酮组患者的手术时间明显更短，且没有与髂骨植骨取材相关的并发症，两者差异均具有统计学意义。
