Chen Fangxiang, He Wenzhuan, Mahaney Kelly, Noeller Jennifer, Mhanna Nakhle, Viljoen Stephen, Torner James, Hitchon Patrick
Department of Neurological Surgery, University of Iowa Hospitals and Clinics (UIHC), 200 Hawkins Drive, Iowa City, USA.
Clin Neurol Neurosurg. 2013 Oct;115(10):2049-55. doi: 10.1016/j.clineuro.2013.07.013. Epub 2013 Jul 31.
The present retrospective study was conducted to compare the clinical and radiographic outcomes in patients undergoing anterior cervical discectomy with fusion (ACDF) using carbon fiber reinforced polymer (CFRP) cages, or allograft.
We retrospectively reviewed cases of ACDF using allograft in 20 patients, and CFRP in 19 who had sequential radiographs before and after surgery, and at 1 year.
There were no apparent significant differences between the 2 groups in age (p=0.057), gender (p=0.635), or complications (p=0.648). At 12 months, there were no cases of construct failure, and fusion appeared to have been achieved in patients of both groups. Lordosis was increased significantly in both groups after surgery (p<0.001 in allograft and p=0.025 in CFRP), and was maintained up until 1 year (p<0.018 in allograft and p=0.05 in CFRP) without a difference between groups (p=0.721). Anterior interbody height was significantly increased (p<0.001 in both groups at each time points) after surgery, without a significant difference between groups (p>0.21). This increase in height was greatest in magnitude immediately after surgery, and declined with the passage of time. There was no detectable health-related quality of life difference between allograft and CFRP group after surgery (p>0.05).
The present study demonstrates that CFRP cages appear to have comparable fusion rates, restoration of lordosis and disc space height, and complication rates to patients who undergo ACDF with allograft.
本回顾性研究旨在比较接受前路颈椎间盘切除融合术(ACDF)并使用碳纤维增强聚合物(CFRP)椎间融合器或同种异体骨移植的患者的临床和影像学结果。
我们回顾性分析了20例使用同种异体骨移植进行ACDF的病例,以及19例使用CFRP并在手术前后及术后1年进行连续X线片检查的病例。
两组在年龄(p = 0.057)、性别(p = 0.635)或并发症(p = 0.648)方面无明显显著差异。在12个月时,两组均未出现内固定失败病例,且两组患者均实现了融合。两组术后脊柱前凸均显著增加(同种异体骨移植组p < 0.001,CFRP组p = 0.025),并维持至1年(同种异体骨移植组p < 0.018,CFRP组p = 0.05),两组间无差异(p = 0.721)。术后前路椎间高度显著增加(两组在各时间点p均< 0.001),组间无显著差异(p > 0.21)。这种高度增加在术后即刻幅度最大,并随时间推移而下降。术后同种异体骨移植组和CFRP组在健康相关生活质量方面无明显差异(p > 0.05)。
本研究表明,CFRP椎间融合器在融合率、脊柱前凸和椎间盘间隙高度恢复以及并发症发生率方面与接受同种异体骨移植ACDF的患者相当。