Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
World Neurosurg. 2019 May;125:e678-e687. doi: 10.1016/j.wneu.2019.01.152. Epub 2019 Feb 5.
Self-locking stand-alone cages can achieve satisfactory clinical results and fusion rate. However, there have been no reports on the causes and relationship of different fusion state. This study is to classify the different fusion states of the index level and to explore the potential contributing factors and links of them.
From June 2008 to October 2011, 42 patients underwent anterior cervical discectomy and fusion with MC+ cages. More than 5 years' follow-up was reviewed. The fusion state and the relevant clinical and radiologic records were reviewed retrospectively.
At the last follow-up, the fusion proportion of type I, II, III, and IV was 11.7%, 16.9%, 26.9%, and 42.9%, respectively. The overall fusion rate was 97.4%. For all the fused types, significant improvement for the visual analog scale, Japanese Orthopaedic Association, and Neck Disability Index scores was found at the last follow-up (P < 0.05). However, there were no significant differences between the 4 types (P > 0.05). For sagittal vertical axis, type IV was significantly larger than that of type I, II, and III (P < 0.05), and for range of motion, type III was significantly larger than that of type II and IV (P < 0.05).
For anterior cervical discectomy and fusion with self-locking stand-alone cages, the fusion of the index level seems to be a progressive dynamic process during the mid-term follow-up, which may be influenced by the location of the cage, the aagittal vertical axis of the index level, and the global range of motion of the cervical spine. Satisfactory clinical results could be achieved by all the fused types.
自锁定独立 cage 可获得满意的临床效果和融合率。然而，尚未有关于不同融合状态的原因和关系的报道。本研究旨在对指数水平的不同融合状态进行分类，并探讨其潜在的影响因素和关联。
回顾性分析 2008 年 6 月至 2011 年 10 月采用 MC+ cage 行前路颈椎间盘切除融合术的 42 例患者的临床资料。患者均获得超过 5 年的随访，对融合状态及相关临床和影像学记录进行回顾性分析。
末次随访时，融合类型Ⅰ、Ⅱ、Ⅲ和Ⅳ的比例分别为 11.7%、16.9%、26.9%和 42.9%，总体融合率为 97.4%。所有融合类型患者的视觉模拟评分、日本矫形协会评分和颈椎残障指数评分在末次随访时均有显著改善（P<0.05），但 4 种融合类型间差异无统计学意义（P>0.05）。在矢状垂直轴方面，Ⅳ型明显大于Ⅰ、Ⅱ和Ⅲ型（P<0.05），而在活动范围方面，Ⅲ型明显大于Ⅱ和Ⅳ型（P<0.05）。
采用自锁定独立 cage 行前路颈椎间盘切除融合术，指数水平的融合在中期随访中似乎是一个渐进的动态过程，可能受到 cage 位置、指数水平矢状垂直轴和颈椎整体活动范围的影响。所有融合类型均可获得满意的临床效果。
