Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany.
Medicina (Kaunas). 2021 Jul 31;57(8):786. doi: 10.3390/medicina57080786.
Stabilization of the spine by cage implantation or autologous pelvic bone graft are surgical methods for the treatment of traumatic spine fractures. These methods serve to stably re-adjust the spine and to prevent late detrimental effects such as pain or increasing kyphosis. They both involve ventral interventions using interbody fusion to replace the intervertebral disc space between the vertebral bodies either by cages or autologous pelvic bone grafts. We examined which of these methods serves the patients better in terms of bone fusion and the long-term clinical outcome. Forty-six patients with traumatic fractures (12 cages; mean age: 54.08/34 pelvic bone grafts; mean age: 42.18) who received an anterior fusion in the thoracic or lumbar spine were included in the study. Postoperative X-ray images were evaluated, and fusion of the stabilized segment was inspected by two experienced spine surgeons. The time to discharge from hospital and gender differences were evaluated. There was a significant difference of the bone fusion rate of patients with autologous pelvic bone grafts in favor of cage implantation ( = 0.0216). Also, the stationary phase of patients who received cage implantations was clearly shorter (17.50 days vs. 23.85 days; = 0.0089). In addition, we observed a significant gender difference with respect to the bony fusion rate in favor of females treated with cage implantations ( < 0.0001). Cage implantations after spinal fractures result in better bony fusion rates as compared to autologous pelvic bone grafts and a shorter stay of the patients in the hospital. Thus, we conclude that cage implantations rather than autologous pelvic bone grafts should be the preferred surgical treatment for stabilizing the spine after fracture.
脊柱稳定通过植入 cage 或自体骨盆骨移植物是治疗创伤性脊柱骨折的手术方法。这些方法旨在稳定地重新调整脊柱，并防止疼痛或增加后凸等后期不利影响。它们都涉及使用前路融合通过 cage 或自体骨盆骨移植物来替代椎体之间的椎间盘空间。我们研究了这些方法中哪一种在骨融合和长期临床结果方面对患者更好。 46 名患有创伤性骨折的患者（12 个 cage；平均年龄：54.08/34 个自体骨盆骨移植物；平均年龄：42.18）接受了胸腰椎前路融合术。研究纳入了接受胸腰椎前路融合术的患者，术后 X 射线图像进行了评估，并由两名经验丰富的脊柱外科医生检查稳定节段的融合情况。评估了患者的住院时间和性别差异。 自体骨盆骨移植物组患者的骨融合率明显高于 cage 植入组（ = 0.0216）。此外，接受 cage 植入的患者的稳定期明显缩短（17.50 天 vs. 23.85 天； = 0.0089）。此外，我们观察到性别差异与接受 cage 植入的女性的骨融合率有关（ < 0.0001）。与自体骨盆骨移植物相比，脊柱骨折后 cage 植入可获得更好的骨融合率，患者在医院的住院时间也更短。因此，我们得出结论，与自体骨盆骨移植物相比，cage 植入应成为骨折后稳定脊柱的首选手术治疗方法。
