Baker Joseph F, Gomez Jaime, Shenoy Kartik, Kim Sarah, Razi Afshin, Kim Yong
Department of Orthopedic Surgery, Waikato Hospital, Hamilton, New Zealand.
Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.
J Spine Surg. 2017 Dec;3(4):596-600. doi: 10.21037/jss.2017.11.06.
Anterior cervical discectomy and fusion (ACDF) may be performed using an interbody cage or graft with an anterior plate or with a stand-alone (SA) interbody device without the anterior plate. The pros and cons of each vary. This study examined the radiographic outcome of the two techniques with a focus on implant subsidence.
A retrospective review of cases of singe level ACDF by a single surgeon was undertaken. Medical and radiographic records were reviewed to determine subsidence, pre- and post-operative segmental and total lordosis in cohorts of both stand-alone and graft-and-plate constructs.
The post-operative radiographs of 35 patients with a SA cage were compared with 41 patients with an allograft block and anterior plate (graft and plate; GP). There was no significant difference in overall subsidence between the two groups although there was a trend toward less clinically significant subsidence (2 mm) in the SA group. For single level ACDF, a SA device appears to be comparable in terms of undesired subsidence.
Further studies with different implants and materials may offer further insight.
颈椎前路椎间盘切除融合术（ACDF）可以使用椎间融合器或植骨并结合前路钢板，也可以使用不带前路钢板的独立（SA）椎间装置。每种方法都有其优缺点。本研究重点关注植入物下沉情况，对这两种技术的影像学结果进行了检查。
对一位外科医生进行的单节段ACDF病例进行回顾性研究。查阅医疗和影像学记录，以确定独立装置和植骨加钢板结构队列中的下沉情况、术前和术后节段性及总体前凸情况。
将35例使用SA椎间融合器患者的术后X线片与41例使用同种异体骨块和前路钢板（植骨加钢板；GP）患者的进行比较。两组之间的总体下沉没有显著差异，尽管SA组有临床意义较小的下沉（2毫米）趋势。对于单节段ACDF，SA装置在不期望的下沉方面似乎具有可比性。
使用不同植入物和材料的进一步研究可能会提供更多见解。
