Oh Si-Hyuck, Yoon Kyeong-Wook, Kim Young-Jin, Lee Sang-Koo
Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Republic of Korea.
Korean J Spine. 2013 Jun;10(2):72-7. doi: 10.14245/kjs.2013.10.2.72. Epub 2013 Jun 30.
To evaluate the utility of anterior cervical discectomy and fusion (ACDF) with polyetheretherketone (PEEK) cage and autograft through long term(average 36 months) follow-up.
Thirty selected patients (male:20/female:10) who suffered from cervical radiculopathy, myelopathy or radiculomyelopathy underwent a single level ACDF with PEEK cage and autograft from iliac crest from March 2006 to July 2008 in single institute. We followed patients for an average 36.4±8.1 months (ranged from 23 to 49 months). The Japanese Orthopedic Association (JOA) score for evaluation of myelopathy and visual analogue scale (VAS) for radiating pain was used to estimate postoperative clinical outcome. Plain x-ray on true lateral standing flexion, extension and neutral position view and 3D CT scan were used every 6 months after surgery during follow-up period.
The mean VAS and JOA scoring improved significantly after the surgery and radiological fusion rate was accomplished by 100% 36 months after the surgery. We had no complication related with the surgery except one case of osteomyelitis. There was one case of Grade I fusion, four cases of grade II, and 25 cases of grade III by radiologic evaluation.
This long term follow-up study for ACDF with PEEK cage shows that this surgical method is comparable with other anterior cervical fusion methods in terms of clinical outcomes and radiologic fusion rate.
通过长期(平均36个月)随访评估采用聚醚醚酮(PEEK)椎间融合器和自体骨移植的颈椎前路椎间盘切除融合术(ACDF)的效用。
2006年3月至2008年7月,在单一机构中,30例(男性20例/女性10例)患有神经根型颈椎病、脊髓型颈椎病或神经根脊髓型颈椎病的患者接受了单节段ACDF手术,使用PEEK椎间融合器和取自髂嵴的自体骨。我们对患者进行了平均36.4±8.1个月(范围为23至49个月)的随访。采用日本骨科协会(JOA)脊髓型颈椎病评估评分和视觉模拟量表(VAS)评估放射痛,以评估术后临床结果。术后随访期间,每6个月进行一次站立位正侧位屈伸及中立位平片X线检查和三维CT扫描。
术后VAS和JOA评分平均显著改善,术后36个月放射学融合率达100%。除1例骨髓炎外,无手术相关并发症。放射学评估显示,I级融合1例,II级4例,III级25例。
这项关于采用PEEK椎间融合器的ACDF的长期随访研究表明,该手术方法在临床结果和放射学融合率方面与其他颈椎前路融合方法相当。