[Application of three-dimensional printed porous titanium alloy cage and poly-ether-ether-ketone cage in posterior lumbar interbody fusion].

OBJECTIVE

To compare the effectiveness between three-dimensional (3D) printed porous titanium alloy cage (3D Cage) and poly-ether-ether-ketone cage (PEEK Cage) in the posterior lumbar interbody fusion (PLIF).

METHODS

A total of 66 patients who were scheduled to undergo PLIF between January 2018 and June 2019 were selected as the research subjects, and were divided into the trial group (implantation of 3D Cage, =33) and the control group (implantation of PEEK Cage, =33) according to the random number table method. Among them, 1 case in the trial group did not complete the follow-up exclusion study, and finally 32 cases in the trial group and 33 cases in the control group were included in the statistical analysis. There was no significant difference in gender, age, etiology, disease duration, surgical segment, and preoperative Japanese Orthopaedic Association (JOA) score between the two groups (>0.05). The operation time, intraoperative blood loss, complications, JOA score, intervertebral height loss, and interbody fusion were recorded and compared between the two groups.

RESULTS

The operations of two groups were completed successfully. There was 1 case of dural rupture complicated with cerebrospinal fluid leakage during operation in the trial group, and no complication occurred in the other patients of the two groups. All incisions healed by first intention. There was no significant difference in operation time and intraoperative blood loss between groups (>0.05). All patients were followed up 12-24 months (mean, 16.7 months). The JOA scores at 1 year after operation in both groups significantly improved when compared with those before operation (<0.05); there was no significant difference between groups (>0.05) in the difference between pre- and post-operation and the improvement rate of JOA score at 1 year after operation. X-ray film reexamination showed that there was no screw loosening, screw rod fracture, Cage collapse, or immune rejection in the two groups during follow-up. At 3 months and 1 year after operation, the rate of intervertebral height loss was significantly lower in the trial group than in the control group (<0.05). At 3 and 6 months after operation, the interbody fusion rating of trial group was significantly better in the trial group than in the control group (<0.05); and at 1 year after operation, there was no significant difference between groups (>0.05).

CONCLUSION

There is no significant difference between 3D Cage and PEEK Cage in PLIF, in terms of operation time, intraoperative blood loss, complications, postoperative neurological recovery, and final intervertebral fusion. But the former can effectively reduce vertebral body subsidence and accelerate intervertebral fusion.