Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Goyangsi, Gyeonggido, Republic of Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
World Neurosurg. 2020 Sep;141:e358-e366. doi: 10.1016/j.wneu.2020.05.143. Epub 2020 May 22.
CaO-SiO-PO-BO bioactive glass ceramic (BGC) is known to chemically bond with bones by forming a hydroxyapatite layer and inducing osteoblastic differentiation. This study was conducted to compare the clinical outcomes, radiographic outcomes, and safety of a CaO-SiO-PO-BO BGC cage in anterior cervical diskectomy and fusion (ACDF) with those of an allograft interbody spacer.
A total of 63 patients who underwent 2-level ACDF to treat degenerative cervical radiculopathy/myelopathy were reviewed. Results from 26 patients who were recruited prospectively using CaO-SiO-PO-BO BGC as a cage material (BGC group) were compared with a historical control group of 37 patients who underwent surgery using an allograft (allograft group). Fusion rates, subsidence, and adjacent segment degeneration were compared between the groups. Demographic data, fusion rates, visual analog scale (VAS) scores for neck or arm pain, Neck Disability Index (NDI) scores, and complications were also compared.
Fusion rates were 88.5% when assessed by interspinous motion and 92.3% when assessed by intragraft bone bridging in the BGC group at 12-month follow-up. The neck pain or arm pain VAS scores and NDI scores significantly improved in both groups. No material-related complications were observed in the BGC group, such as graft resorption and breakage. Fusion rates, subsidence, neck pain or arm pain VAS scores, and NDI scores did not significantly differ between the BGC and allograft groups.
CaO-SiO-PO-BO BGC cage was effective and safe when used in ACDF, conferring a high fusion rate and favorable clinical outcomes similar to those of the allograft.
已知 CaO-SiO-PO-BO 生物活性玻璃陶瓷 (BGC) 通过形成羟磷灰石层并诱导成骨细胞分化而与骨骼化学结合。本研究旨在比较 CaO-SiO-PO-BO BGC 笼在颈椎前路椎间盘切除融合术 (ACDF) 中的临床结果、影像学结果和安全性与同种异体椎间间隔物的结果。
回顾了 63 例接受 2 级 ACDF 治疗退行性颈椎神经根病/颈椎病的患者。结果来自 26 例前瞻性使用 CaO-SiO-PO-BO BGC 作为笼材料的患者（BGC 组），并与 37 例使用同种异体（同种异体组）进行手术的历史对照组进行比较。比较两组之间的融合率、沉降和相邻节段退变。还比较了人口统计学数据、融合率、颈部或手臂疼痛的视觉模拟量表 (VAS) 评分、颈椎功能障碍指数 (NDI) 评分和并发症。
在 12 个月随访时，通过棘突间运动评估，BGC 组的融合率为 88.5%，通过骨桥内融合率为 92.3%。两组的颈部疼痛或手臂疼痛 VAS 评分和 NDI 评分均显著改善。BGC 组未观察到与材料相关的并发症，如移植物吸收和断裂。BGC 和同种异体组之间的融合率、沉降、颈部或手臂疼痛 VAS 评分和 NDI 评分没有显著差异。
在 ACDF 中使用 CaO-SiO-PO-BO BGC 笼是有效且安全的，可获得高融合率和与同种异体相似的良好临床结果。
