Department of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
Arch Orthop Trauma Surg. 2014 May;134(5):611-8. doi: 10.1007/s00402-014-1972-1. Epub 2014 Mar 28.
A growing number of industrially manufactured implants have been developed in the last years for vertebral replacement in anterior cervical corpectomy and fusion (ACCF). Polyetheretherketone (PEEK)-cages are used in many centers, but outcome reports are scarce. This study assesses the clinical and radiological outcome after one- or two-level ACCF by the use of a PEEK-cage augmented by a plate-screw osteosynthesis.
A total of 21 patients received one-level (18 patients) or two-level (3 patients) ACCF by a PEEK-cage and plate-screw osteosynthesis for multilevel degenerative stenosis. The Visual Analogue Scale, Nurick Score, Neck Disability Index and European Myelopathy Score were used for clinical assessment. Radiological outcome-osseous fusion and loss of height-was evaluated by CT.
The mean follow-up was 28 ± 12 months. In 19 patients, bony fusion was achieved after the primary operation. Graft failure that required surgical revision occurred in two patients. In these patients, osseous fusion was achieved after the second operation. Myelopathy improved significantly. The loss of height was 2.2 ± 2.3 and 5.3 ± 2.1 mm after one- and two-level ACCF, respectively.
Anterior corpectomy and fusion by a PEEK-cage and plate-screw osteosynthesis resulted in clinical improvement in all patients. Bony fusion was achieved in all patients in the long run. PEEK cages are allegedly less rigid than other xenografts. Similar to those, however, their use bears the risk of early cage-dislocation and subsidence. A comparison of industrial xenografts and autologous bone implants is required to challenge the different fusion techniques.
近年来，为了在前路颈椎椎体次全切除融合术（ACCF）中进行椎体置换，已经开发出越来越多的工业制造植入物。聚醚醚酮（PEEK）笼在许多中心得到使用，但结果报告却很少。本研究通过使用 PEEK 笼增强板螺钉骨合成术评估了进行 1 或 2 个水平 ACCF 的临床和放射学结果。
共有 21 名患者因多节段退行性狭窄而行 1 个水平（18 名患者）或 2 个水平（3 名患者）ACCF，通过 PEEK 笼和板螺钉骨合成术。使用视觉模拟量表，Nurick 评分，颈部残疾指数和欧洲脊髓病评分进行临床评估。通过 CT 评估放射学结果-骨融合和高度丢失。
平均随访时间为 28±12 个月。在 19 名患者中，初次手术后达到了骨融合。两名患者发生了需要手术修正的移植物失败。在这些患者中，第二次手术后实现了骨融合。脊髓病明显改善。一次和两次 ACCF 后的高度丢失分别为 2.2±2.3 和 5.3±2.1mm。
前路椎体次全切除融合术和板螺钉骨合成术通过 PEEK 笼和板螺钉骨合成术可使所有患者的临床状况得到改善。从长远来看，所有患者均实现了骨融合。据称，PEEK 笼比其他异种移植物的刚性小。然而，与那些一样，它们的使用也存在早期笼脱位和下沉的风险。需要对工业异种移植物和自体骨植入物进行比较，以挑战不同的融合技术。
