Kwon O Ik, Son Dong Wuk, Lee Sang Weon, Song Geun Sung
Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Korean J Spine. 2016 Sep;13(3):91-96. doi: 10.14245/kjs.2016.13.3.91. Epub 2016 Sep 30.
Anterior cervical discectomy and fusion (ACDF) is a choice of surgical procedure for cervical degenerative diseases associated with radiculopathy or myelopathy. However, the patients undergoing ACDF still have problems. The purpose of the present study is to evaluate the radiologic results of 3 different methods in single-level ACDF.
We conducted a retrospective collection of radiological data from January 2011 to December 2014. A total of 67 patients were included in this study. The patients were divided into 3 groups by operation procedure: using stand-alone cage (group cage, n=20); polyether-ether-ketone (PEEK)-titanium combined anchored cage (group AC, n=21); and anterior cervical cage-plate (group CP, n=26). Global cervical lordosis (C2-C7 Cobb angle), fused segment height, fusion rate, and cervical range of motion (ROM) were measured and analyzed at serial preoperative, postoperative, 6-month, and final 1-year follow-up.
Successful bone fusion was achieved in all patients at the final follow-up examination; however, the loss of disc height over 3 mm at the surgical level was observed in 6 patients in group cage. Groups AC and CP yielded significantly better outcomes than group cage in fused segment height and cervical ROM(p=0.01 and p=0.02, respectively). Furthermore, group AC had similar radiologic outcomes to those of group CP.
The PEEK-titanium combined anchored cage may be a good alternative procedure in terms of reducing complications induced by plate after ACDF.
颈椎前路椎间盘切除融合术(ACDF)是治疗伴有神经根病或脊髓病的颈椎退行性疾病的一种手术选择。然而,接受ACDF手术的患者仍存在问题。本研究的目的是评估单节段ACDF中3种不同方法的影像学结果。
我们回顾性收集了2011年1月至2014年12月的影像学数据。本研究共纳入67例患者。根据手术方式将患者分为3组:使用单独椎间融合器(椎间融合器组,n = 20);聚醚醚酮(PEEK)-钛联合锚定椎间融合器(AC组,n = 21);以及颈椎前路椎间融合器-钢板(CP组,n = 26)。在术前、术后、6个月和最后1年随访时,测量并分析颈椎整体前凸(C2-C7 Cobb角)、融合节段高度、融合率和颈椎活动度(ROM)。
在最后一次随访检查时,所有患者均实现了成功的骨融合;然而,椎间融合器组有6例患者在手术节段出现了超过3 mm的椎间盘高度丢失。AC组和CP组在融合节段高度和颈椎ROM方面的结果明显优于椎间融合器组(分别为p = 0.01和p = 0.02)。此外,AC组的影像学结果与CP组相似。
就减少ACDF术后钢板引起的并发症而言,PEEK-钛联合锚定椎间融合器可能是一种较好的替代手术方法。