Gok Haydar, Onen Mehmet Resit, Yildirim Hatice, Gulec Ilker, Naderi Sait
Umraniye Training & Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2016;26(1):105-10. doi: 10.5137/1019-5149.JTN.9376-13.1.
Cervical disc herniation (CDH) can be treated using different anterior and posterior methods. Anterior cervical discectomy and fusion (ACDF) is currently gold standard and provides bony fusion and good clinical outcome. Recently many studies reported good clinical and radiological outcomes in cases who underwent anterior cervical discectomy (ACD) and reconstruction with empty cage. This study aimed to review our results after cervical microdiscectomy reconstructed with empty polyether ether ketone (PEEK) cage.
Twenty-five cases with single level CDH who underwent microdiscectomy were included to this study. Reconstruction was performed using empty bladed cervical PEEK cages. Clinical (Visual analogue scale (VAS) and Odom scores) and radiological results (intervertebral disc and foraminal heights, mean cervical spine lordosis angle, and fusion rate) were reviewed one day and one year after surgery.
There were 18 males and 7 females, aged between 25 and 54 years (mean: 40.8). Mean neck and arm VAS scores reduced from 2.9 to 1.4, and from 7.2 to 1.8, respectively. Odom scores were found to be 1.6 and 1.4 at 1st day and one year postoperatively, respectively. Subsidence was seen in three cases (12%). There was no significant change in heights of neural foramina and intervertebral discs, and no change in cervical spine lordosis, when compared postoperative 1st day and one year radiographs. Fusion was detected in 92% of cases in one year.
Bladed cervical cages are safe with almost no risk of dislocation. Empty cages provide acceptable rates of fusion and subsidence.
颈椎间盘突出症（CDH）可采用不同的前路和后路方法进行治疗。颈椎前路椎间盘切除融合术（ACDF）是目前的金标准，可实现骨性融合并取得良好的临床效果。最近，许多研究报道了接受颈椎前路椎间盘切除（ACD）并使用空椎间融合器重建的病例取得了良好的临床和影像学效果。本研究旨在回顾我们使用空聚醚醚酮（PEEK）椎间融合器重建颈椎显微椎间盘切除术后的结果。
本研究纳入了25例接受显微椎间盘切除术的单节段CDH患者。使用空的带刃颈椎PEEK椎间融合器进行重建。在术后1天和1年时评估临床结果（视觉模拟评分（VAS）和奥多姆评分）和影像学结果（椎间盘高度、椎间孔高度、颈椎前凸平均角度和融合率）。
患者中男性18例，女性7例，年龄在25至54岁之间（平均40.8岁）。颈部和手臂的平均VAS评分分别从2.9降至1.4，从7.2降至1.8。术后第1天和1年时的奥多姆评分分别为1.6和1.4。3例（12%）出现下沉。术后第1天和1年的X线片对比显示，神经椎间孔和椎间盘高度无明显变化，颈椎前凸也无改变。1年内92%的病例检测到融合。
带刃颈椎椎间融合器安全，几乎没有脱位风险。空椎间融合器的融合率和下沉率可接受。
