Li Zhonghai, Zhao Yantao, Tang Jiaguang, Ren Dongfeng, Guo Jidong, Wang Huadong, Li Li, Hou Shuxun
Department of Orthopedics, First Affiliated Hospital of PLA General Hospital, Beijing, The People's Republic of China.
Beijing Engineering Research Center of Orthopedic Implants, Beijing, The People's Republic of China.
Eur Spine J. 2017 Apr;26(4):1129-1139. doi: 10.1007/s00586-016-4739-2. Epub 2016 Aug 23.
To compare perioperative parameters, clinical outcomes, radiographic parameters, and complication rates of the new zero-profile, stand-alone Fidji cervical cage with those of the stand-alone cages with a titanium plate for anterior cervical discectomy and fusion (ACDF) for the surgical treatment of single- and multilevel cervical degenerative disc disease (DDD).
Between October 2009 and December 2013, 152 consecutive patients [86 males and 52 females; mean age 51.0 years (range 30-69 years)] with cervical DDD, who underwent surgery and were followed for more than 2 years, were enrolled in this study and divided into the cage group and plate group. The study compared perioperative parameters, surgery-related and implant-related complication rates, clinical outcomes, and radiologic parameters.
The clinical and radiologic results in both groups were satisfactory after a minimum 2-year follow-up. No significant differences between the cage group and plate group in terms of improvement in the 36-Item Short Form Health Survey, visual analogue scale, Neck Disability Index, Japanese Orthopedic Association scores, disc height, mean fusion time, fusion rate, adjacent segment degeneration, and restoration of cervical lordosis, but the cage group was associated with a lower risk of postoperative dysphagia, shorter operation time, less blood loss, less cost of index surgery, and relatively greater simplicity than the plate group.
The zero-profile, stand-alone Fidji cervical cage for ACDF is an effective, reliable, and safe alternate to the conventional method for the treatment of cervical DDD. However, there is no definitive evidence that Fidji cervical cage has better intermediate-term outcomes than the stand-alone cages with a titanium plate for ACDF.
比较新型零轮廓、独立式Fidji颈椎椎间融合器与带钛板的独立式椎间融合器在前路颈椎间盘切除融合术(ACDF)治疗单节段和多节段颈椎退行性椎间盘疾病(DDD)时的围手术期参数、临床疗效、影像学参数及并发症发生率。
2009年10月至2013年12月,152例连续的颈椎DDD患者[86例男性,52例女性;平均年龄51.0岁(范围30 - 69岁)]接受手术并随访超过2年,纳入本研究并分为椎间融合器组和钛板组。研究比较了围手术期参数、手术相关及植入物相关并发症发生率、临床疗效和影像学参数。
经过至少2年的随访,两组的临床和影像学结果均令人满意。在36项简明健康调查、视觉模拟评分、颈部功能障碍指数、日本骨科协会评分、椎间盘高度、平均融合时间、融合率、相邻节段退变及颈椎前凸恢复方面,椎间融合器组和钛板组之间无显著差异,但椎间融合器组术后吞咽困难风险较低,手术时间较短,出血量较少,初次手术费用较低,且比钛板组相对更简便。
用于ACDF的零轮廓、独立式Fidji颈椎椎间融合器是治疗颈椎DDD的传统方法的一种有效、可靠且安全的替代方法。然而,没有确凿证据表明Fidji颈椎椎间融合器在中期疗效上优于用于ACDF的带钛板的独立式椎间融合器。