Ashour Ahmed M, Abdelmohsen Ibrahim, Sawy Medhat El, Toubar Ahmed Faisal
Department of Neurosurgery, Ain Shams University, Cairo, Egypt.
Department of Neurosurgery, El-Menia University, Menia, Egypt.
J Craniovertebr Junction Spine. 2020 Apr-Jun;11(2):118-123. doi: 10.4103/jcvjs.JCVJS_62_20. Epub 2020 Jun 5.
Anterior cervical discectomy with fusion became the most frequently performed technique for the treatment of symptoms related to cervical disc prolapse. Multilevel anterior cervical discectomy has been combined with anterior cervical plate application to help maintain the cervical lordosis and enhance fusion. This was associated with more soft-tissue separation and retraction with increased incidence of surgically related complications and postoperative dysphagia.
The aim of this study is to evaluate the safety and efficacy of the stand-alone cervical polyetheretherketone (PEEK) cages in four-level discectomy and to determine if it is possible to avoid anterior plate fixation and to achieve satisfactory outcomes.
This is a retrospective study which was performed between June 2011 and December 2018 at one institute. The clinical and radiological data were collected from patients who underwent successive four-level anterior cervical discectomy and fusion with PEEK cages for degenerative cervical disc disease without plate fixation.
This study included 66 patients, 35 males and 31 females. The follow-up period was 24 months. Mean Japanese Orthopedic Association scores were 13.3 ± 1.41 preoperative and 15.9 ± 0.86 postoperative ( = 0.046). The cervical curvature index "Ishihara" (ICI) was 9.9 ± 5.90 preoperative and the mean of ICI was 10.5 ± 6.65 postoperative, which is insignificant, = 0.7). The lordotic curvature according to these results was preserved till the end of the year and half of the follow-up period postoperative.
Consecutive four-level anterior discectomy with PEEK cage interbody fusion without plate and screw is a safe and effective procedure in the absence of instability, and it may be a reliable alternative for the treatment of multilevel cervical disc.
颈椎前路椎间盘切除融合术成为治疗颈椎间盘突出相关症状最常用的技术。多节段颈椎前路椎间盘切除术已与颈椎前路钢板应用相结合，以帮助维持颈椎前凸并增强融合。这与更多的软组织分离和牵拉有关，手术相关并发症和术后吞咽困难的发生率增加。
本研究的目的是评估独立颈椎聚醚醚酮（PEEK）椎间融合器在四级椎间盘切除术中的安全性和有效性，并确定是否有可能避免前路钢板固定并取得满意的结果。
这是一项回顾性研究，于2011年6月至2018年12月在一家机构进行。收集了因退行性颈椎间盘疾病接受连续四级颈椎前路椎间盘切除并使用PEEK椎间融合器融合且未进行钢板固定的患者的临床和放射学数据。
本研究纳入66例患者，其中男性35例，女性31例。随访期为24个月。术前日本骨科协会平均评分为13.3±1.41，术后为15.9±0.86（P = 0.046）。颈椎曲度指数“Ishihara”（ICI）术前为9.9±5.90，术后ICI平均值为10.5±6.65，差异无统计学意义（P = 0.7）。根据这些结果，前凸曲度在术后随访期的一年半内得以保留。
在不存在不稳定的情况下，连续四级颈椎前路椎间盘切除并使用PEEK椎间融合器进行椎间融合而不使用钢板和螺钉是一种安全有效的手术方法，可能是治疗多节段颈椎间盘疾病的可靠替代方法。
