Wang Shanxi, Fang Xuan, Qu Yunkun, Lu Rui, Yu Xiaojun, Jing Shaoze, Ding Qing, Liu Chaoxu, Wu Hua, Liu Yang
Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Orthopedics, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
Front Surg. 2023 Feb 17;10:1096080. doi: 10.3389/fsurg.2023.1096080. eCollection 2023.
To assess the clinical and radiographical outcomes of 3-level anterior cervical discectomy and fusion (ACDF) with a 3D-printed titanium cage in treating degenerative cervical spondylosis.
In this study, 25 patients with degenerative cervical spondylosis who underwent 3-level ACDF using a 3D-printed titanium cage from March 2019 to June 2021 were retrospectively enrolled. The patient-reported outcome measures (PROMs) were evaluated by visual analog scale (VAS) for the neck (VAS-neck) and arm pain (VAS-arm), Neck Disability Index (NDI) score, Japanese Orthopedic Association (JOA) score, SF-12 concise health survey, and the Odom criteria. The radiographical parameters, including C2-C7 lordosis, segmental angle, segmental height, and subsidence, were assessed. The mean duration of follow-up was 25.6 months.
Bony fusion was achieved in all patients (100%). In three patients (12%) mild dysphagia was observed during the follow-up. The VAS-neck, VAS-arm, NDI score, JOA score, SF-12 score, C2-C7 lordosis, and segmental angle improved noticeably at the latest follow-up. Based on the Odom criteria, 22 patients (88%) reported satisfactory (excellent or good). The mean loss of C2-C7 lordosis and segmental angle between the immediate postoperative and the latest follow-up values were 1.6° ± 0.5° and 1.1° ± 0.5°, respectively. The mean subsidence was 0.9 ± 0.6 mm.
In patients with multi-level degenerative cervical spondylosis, 3-level ACDF using the 3D-printed titanium cage can effectively relieve the symptoms, stabilize the spine, and restore segmental height and cervical curvature. It is proven to be a reliable option for patients with 3-level degenerative cervical spondylosis. However, a future comparative study involving a larger population and longer follow-up time may be required to further evaluate the safety, efficacy and outcomes of our preliminary results.
评估三级前路颈椎间盘切除融合术（ACDF）联合3D打印钛笼治疗退行性颈椎病的临床和影像学结果。
本研究回顾性纳入了2019年3月至2021年6月期间接受三级ACDF联合3D打印钛笼治疗的25例退行性颈椎病患者。通过视觉模拟量表（VAS）评估颈部疼痛（VAS-颈部）和手臂疼痛（VAS-手臂）、颈部功能障碍指数（NDI）评分、日本骨科协会（JOA）评分、SF-12简明健康调查以及奥多姆标准来评价患者报告的结局指标（PROMs）。评估包括C2-C7前凸、节段角度、节段高度和沉降在内的影像学参数。平均随访时间为25.6个月。
所有患者（100%）均实现了骨融合。随访期间，3例患者（12%）出现轻度吞咽困难。在最近一次随访时，VAS-颈部、VAS-手臂、NDI评分、JOA评分、SF-12评分、C2-C7前凸和节段角度均有显著改善。根据奥多姆标准，22例患者（88%）报告结果满意（优或良）。术后即刻与最近一次随访时C2-C7前凸和节段角度的平均丢失分别为1.6°±0.5°和1.1°±0.5°。平均沉降为0.9±0.6毫米。
对于多节段退行性颈椎病患者，三级ACDF联合3D打印钛笼可有效缓解症状、稳定脊柱，并恢复节段高度和颈椎曲度。已证明这是治疗三级退行性颈椎病患者的可靠选择。然而，可能需要未来进行一项涉及更大样本量和更长随访时间的比较研究，以进一步评估我们初步结果的安全性、有效性和结局。
