Milavec Helena, Kellner Christoph, Ravikumar Nivetha, Albers Christoph E, Lerch Till, Hoppe Sven, Deml Moritz C, Bigdon Sebastian F, Kumar Naresh, Benneker Lorin M
Department of Orthopaedic Surgery, Spine Unit, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Department of Orthopaedic Surgery, National University Health System (NUHS)-Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore.
J Funct Biomater. 2019 Jul 2;10(3):29. doi: 10.3390/jfb10030029.
Carbon fibre reinforced polyether ether ketone (CFR-PEEK) is a suitable material to replace metal implants in orthopaedic surgery. The radiolucency of CFR-PEEK allows an optimal visualisation of the bone and soft tissue structures. We aimed to assess the performance and radiological and clinical outcomes of anterior cervical discectomy and fusion (ACDF) with CFR-PEEK anterior cervical plating (ACP) under first use clinical conditions. We retrospectively studied the prospectively-collected data of 42 patients who underwent ACDF with CFR-PEEK ACP between 2011 and 2016. We assessed clinical outcome (Odom's criteria, complications) and radiological parameters (global and segmental cervical lordosis, Bridwell score for fusion, adjacent segment degeneration) preoperatively, immediately post-operatively, and after a 12-month follow-up period. Patients' satisfaction was excellent, good, fair, and poor in 12, 19, 3, and 1 patients, respectively. Two patients developed dysphagia. No hardware failure occurred. Compared with preoperative radiographs, we observed a gain of global cervical lordosis and segmental lordosis (7.4 ± 10.1 and 5.6 ± 7.1 degrees, respectively) at the 12-month follow-up. Bridwell IF grades I, II, and III were observed in 22, 6, and 7 patients, respectively. The 12-month adjacent segment degeneration-free and adjacent segment disease-free survival rates were 93.1% and 96.3%, respectively. We observed a dysphagia rate of 5.7% and a reoperation rate of 4.8%. In conclusion, CFR-PEEK ACP shows positive outcomes in terms of implant safety, restoration of cervical lordosis, and functional recovery, and is suitable for ACDF.
碳纤维增强聚醚醚酮（CFR-PEEK）是骨科手术中替代金属植入物的合适材料。CFR-PEEK的射线可透过性使骨骼和软组织结构得到最佳可视化。我们旨在评估在首次使用的临床条件下，采用CFR-PEEK前路颈椎钢板（ACP）进行颈椎前路椎间盘切除融合术（ACDF）的性能、放射学和临床结果。我们回顾性研究了2011年至2016年间42例行ACDF并使用CFR-PEEK ACP患者的前瞻性收集数据。我们在术前、术后即刻以及12个月随访期评估临床结果（奥多姆标准、并发症）和放射学参数（颈椎整体和节段性前凸、融合的布里德韦尔评分、相邻节段退变）。患者满意度分别为优12例、良19例、中3例和差1例。2例患者出现吞咽困难。未发生内固定失败。与术前X线片相比，在12个月随访时我们观察到颈椎整体前凸和节段性前凸增加（分别为7.4±10.1度和5.6±7.1度）。分别在22例、6例和7例患者中观察到布里德韦尔I级、II级和III级融合。12个月时相邻节段无退变和无相邻节段疾病生存率分别为93.1%和96.3%。我们观察到吞咽困难发生率为5.7%，再次手术率为4.8%。总之，CFR-PEEK ACP在植入物安全性、颈椎前凸恢复和功能恢复方面显示出积极结果，适用于ACDF。
