ZW-O Zentrum für - Wirbelsäulenchirurgie, Osnabrück, Germany.
Department of Radiology, Clinicum Osnabrueck, Osnabrueck, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2024 May;85(3):262-268. doi: 10.1055/s-0043-1770694. Epub 2023 Jul 28.
The implantation of a spacer is a common practice after anterior diskectomy in cervical spine. Polyether ether ketone (PEEK) cages have replaced titanium implants due to their better radiologic visibility and appearance in postoperative magnetic resonance imaging (MRI) scans. However, PEEK showed apparently higher nonunion rates than titanium cages. The aim of the study was to evaluate the fusion behavior of plain PEEK cages in comparison to titanium-coated PEEK (TiPEEK) cages.
We randomized 104 patients with single-level cervical radiculopathy or mild myelopathy. They were divided into two groups of 52 patients each, receiving either a PEEK cage or the titanium-coated variant of the same cage type. The 1- and 2-year follow-ups were completed by 43 patients in the PEEK group and by 50 patients in the TiPEEK group. Fusion was determined by plain X-ray and lateral functional X-ray.
Two years after surgery, a complete fusion was observed in 37 patients of the PEEK group (86%). Six cases were considered as nonunions. In the TiPEEK group, we found 41 fusions (82%) and 9 nonunions at this time. The difference was not considered significant ( = 0.59). The clinical evaluation of the two groups showed no difference in the neurologic examination as well in the pain scores over the time period.
Despite some assumptions about an advantage of TiPEEK over PEEK cages for fusion in cervical spine surgery, this prospective randomized controlled study did not find an accelerated or improved fusion using TiPEEK for anterior cervical diskectomy.
颈椎前路椎间盘切除术后植入间隔器是一种常见的做法。由于在术后磁共振成像（MRI）扫描中具有更好的放射学可见性和外观，聚醚醚酮（PEEK）笼已取代钛植入物。然而，PEEK 显示出明显更高的非融合率，而不是钛笼。本研究的目的是评估普通 PEEK 笼与钛涂层 PEEK（TiPEEK）笼的融合行为。
我们随机选择了 104 例单节段颈椎神经根病或轻度脊髓病患者。他们分为两组，每组 52 例，分别接受 PEEK 笼或同种笼型的钛涂层变体。PEEK 组有 43 例和 TiPEEK 组有 50 例完成了 1 年和 2 年的随访。融合通过普通 X 射线和侧位功能 X 射线确定。
手术后 2 年，PEEK 组有 37 例（86%）完全融合。6 例被认为是非融合。在 TiPEEK 组，此时有 41 例融合（82%）和 9 例非融合。差异无统计学意义（=0.59）。两组的临床评估在神经检查和疼痛评分方面在整个时间段内均无差异。
尽管有人假设 TiPEEK 笼在颈椎前路椎间盘切除术中比 PEEK 笼具有融合优势，但这项前瞻性随机对照研究并未发现使用 TiPEEK 进行前路颈椎间盘切除术后融合的加速或改善。
