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用于腰椎前路椎间融合术的钛/聚醚醚酮组合式椎间融合器:早期临床及影像学结果

Combination Ti/PEEK ALIF cage for anterior lumbar interbody fusion: Early clinical and radiological results.

作者信息

Mobbs Ralph Jasper, Phan Kevin, Assem Yusuf, Pelletier Matthew, Walsh William R

机构信息

University of New South Wales (UNSW), Sydney, Australia; Department of Spine Surgery, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia.

University of New South Wales (UNSW), Sydney, Australia; NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, Australia.

出版信息

J Clin Neurosci. 2016 Dec;34:94-99. doi: 10.1016/j.jocn.2016.05.028. Epub 2016 Jul 26.

Abstract

Anterior lumbar interbody fusion (ALIF) is a common procedure for patients with degenerative pathologies of the lumbar spine. In this study, the clinical and radiological outcomes of a combination titanium/polyetheretherketone (Ti/PEEK) ALIF cages in one, two and three-level surgery were evaluated. Over an 18-month time period, a prospective single surgeon series of 20 implants (15 patients) were included in the study, with minimum 10-months follow-up. From these 15 patients, two were supplemented with posterior percutaneous pedicle screw fixation for additional stability. Radiological follow-up with fine cut CT scan at 9-12months was performed to evaluate early fusion rates, and integration of the Titanium/PEEK cage at the endplate junction. 20 implants were followed for a minimum of 10months, and a mean of 15months. A 95% (19/20 implants) fusion rate with no implant related complications was achieved at the mean 15-month postoperative mark. Patients experienced statistically significant improvement in pain and functional outcomes (SF12 and ODI) compared to their pre-operative status. A single patient with a non-union at L5/S1 (smoker) did not experience any improvement in symptoms. A Ti-PEEK cage, with allograft and BMP-2 to achieve interbody fusion is an effective implant for use in anterior lumbar surgery with high fusion rates, no lucency around the titanium endplates at follow-up, and with promising early results.

摘要

腰椎前路椎间融合术(ALIF)是治疗腰椎退行性病变患者的常见手术。在本研究中,评估了钛/聚醚醚酮(Ti/PEEK)组合式椎间融合器在单节段、双节段和三节段手术中的临床和影像学结果。在18个月的时间里,该研究纳入了由同一位外科医生进行的20例植入手术(15名患者)的前瞻性系列病例,随访时间至少为10个月。在这15名患者中,有2名患者补充了后路经皮椎弓根螺钉固定以增强稳定性。在9至12个月时进行高分辨率CT扫描进行影像学随访,以评估早期融合率以及钛/聚醚醚酮椎间融合器在终板连接处的融合情况。对20个植入物进行了至少10个月、平均15个月的随访。术后15个月时,融合率达到95%(20个植入物中的19个),且无植入物相关并发症。与术前状态相比,患者在疼痛和功能结果(SF12和ODI)方面有统计学意义的显著改善。一名L5/S1节段不融合的患者(吸烟者)症状未得到任何改善。使用同种异体骨和BMP-2的Ti-PEEK椎间融合器是一种有效的植入物,用于腰椎前路手术时融合率高,随访时钛终板周围无透亮区,且早期结果良好。

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