Department of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed - St. Raphael Hospital in Cracow, ul. Adama Bochenka 12, 30-693, Cracow, Poland.
Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland.
Acta Neurochir (Wien). 2022 Jun;164(6):1501-1507. doi: 10.1007/s00701-022-05217-7. Epub 2022 Apr 26.
Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed procedures for degenerative cervical disease. The evaluation of fusion status is still not fully standardized, and a variety of measurement methods are used. This study presents our own evaluation of fusion by comparing two types of implants.
A total of 170 disc spaces were operated on in 104 patients using PEEK (polyetheretherketone) cages and titanium-coated (TC) PEEK cages. Patients were assigned to a specific implant using a randomisation table. Fusion status was evaluated based on functional radiographs and CT scans obtained at 12 months post-surgery. Multivariate mixed-effects logistic regression models were performed to assess the association of type of implant with different fusion rates.
At 12 months post-surgery, CT scans were performed in 86 patients (a total of 144 disc spaces) and conventional radiographs were obtained in 102 (a total of 166 disc spaces). Complete fusion was demonstrated in 101 cases (71.1%), partial fusion in 43 cases (29.9%). There were no cases of absence of fusion. A total of 85 PEEK cages (59%) and 59 TC-PEEK cages (41%) were implanted. For PEEK cages, complete fusion was seen in 75 (88.2%) disc spaces, compared to 26 (44.1%) achieved with TC-PEEK cages. A significantly higher proportion of complete fusions (B = 15.58; P < 0.0001) after 12 months was observed with PEEK implants compared to TC-PEEK implants.
Complete fusion was noted at 12 months post-surgery significantly more frequently with PEEK implants compared to TC-PEEK implants.
颈椎前路椎间盘切除融合术（ACDF）是治疗退行性颈椎疾病最常用的手术之一。融合状态的评估尚未完全标准化，有多种测量方法。本研究通过比较两种类型的植入物来评估融合情况。
在 104 例患者中，共对 170 个椎间盘进行了手术，使用聚醚醚酮（PEEK）笼和钛涂层（TC）PEEK 笼。使用随机数表将患者分配到特定的植入物中。术后 12 个月，通过功能 X 线片和 CT 扫描评估融合情况。使用多变量混合效应逻辑回归模型评估植入物类型与不同融合率的相关性。
术后 12 个月，86 例患者（共 144 个椎间盘）进行了 CT 扫描，102 例患者（共 166 个椎间盘）进行了常规 X 线片检查。101 例（71.1%）患者表现为完全融合，43 例（29.9%）患者表现为部分融合。无融合缺失病例。共植入 85 个 PEEK 笼（59%）和 59 个 TC-PEEK 笼（41%）。PEEK 笼中，75 个（88.2%）椎间盘实现完全融合，而 TC-PEEK 笼中仅 26 个（44.1%）实现完全融合。与 TC-PEEK 植入物相比，PEEK 植入物在术后 12 个月时完全融合的比例显著更高（B=15.58；P<0.0001）。
与 TC-PEEK 植入物相比，PEEK 植入物在术后 12 个月时更常出现完全融合。
