Croft Andrew J, Wiedel Abigail J, Steinle Anthony M, Zakieh Omar, Pennings Jacquelyn S, Davidson Claudia, Zuckerman Scott L, Abtahi Amir M, Stephens Byron F
Department of Orthopedic Surgery, Vanderbilt University Medical Center, Nashville, USA.
Steamboat Orthopaedics and Spine Institute, Steamboat Springs, USA.
Spine Surg Relat Res. 2024 Feb 14;8(4):399-408. doi: 10.22603/ssrr.2023-0140. eCollection 2024 Jul 27.
Anterior cervical discectomy and fusion (ACDF) has proven to be a clinically efficient and cost-effective method for treating patients with degenerative cervical spine conditions. New intervertebral implant products are being developed to improve fusion and stability while decreasing complications. This study assesses the effectiveness of Tritanium C (Tri-C) Anterior Cervical Cage (Stryker) in the treatment of degenerative disk disease (DDD) of the cervical spine compared with polyetheretherketone (PEEK) cages.
A retrospective cohort analysis was conducted using data prospectively collected from two institutions. Patients who underwent ACDFs for DDD using either the Tri-C cage or PEEK cage were identified. The patients' demographics, comorbidities, operative variables, and baseline patient-reported outcomes (PROs) were collected. PROs included the Neck Disability Index (NDI) and numeric rating scale (NRS) for neck and arm pain. The primary outcomes included 3- and 12-month PROs as well as the rates of 90-day readmission, 90-day reoperation, and perioperative complication. The radiographic outcomes included rates of subsidence, cage movement, and successful fusion within 12 months. Multivariate linear regression models were run to identify variables predictive of 12-month PROs.
A total of 275 patients who underwent ACDF were included in this study and were divided into two groups: PEEK (n=213) and Tri-C (n=62). Both groups showed improvement in neck and arm pain and NDI postoperatively. When Tri-C and PEEK were compared, no significant differences were observed in the 3- or 12-month changes in neck or arm pain or NDI. Furthermore, there were no differences in the rates of 90-day readmission, 90-day reoperation, and perioperative complication. Regression analysis revealed that Tri-C vs. PEEK was not a significant predictor of any outcome.
Our results indicate that the use of porous titanium Tri-C cage during ACDFs is an effective method for managing cervical DDD in terms of PROs, perioperative morbidity, and radiologic parameters. No significant difference was observed in any clinical outcome between patients undergoing ACDF using the Tri-C cage and those in whom the PEEK cage was used.
III.
颈椎前路椎间盘切除融合术（ACDF）已被证明是治疗颈椎退行性疾病患者的一种临床有效且具有成本效益的方法。新型椎间植入产品正在不断研发，以提高融合效果和稳定性，同时减少并发症。本研究评估了Tritanium C（Tri-C）颈椎前路椎间融合器（史赛克公司）与聚醚醚酮（PEEK）椎间融合器相比，在治疗颈椎退行性椎间盘疾病（DDD）方面的有效性。
采用前瞻性收集自两家机构的数据进行回顾性队列分析。确定使用Tri-C椎间融合器或PEEK椎间融合器进行DDD的ACDF手术的患者。收集患者的人口统计学资料、合并症、手术变量以及患者报告的基线结局指标（PROs）。PROs包括颈部功能障碍指数（NDI）以及颈部和手臂疼痛的数字评分量表（NRS）。主要结局指标包括3个月和12个月时的PROs，以及90天再入院率、90天再次手术率和围手术期并发症发生率。影像学结局指标包括下沉率、椎间融合器移位率以及12个月内的成功融合率。运行多变量线性回归模型以确定预测12个月PROs的变量。
本研究共纳入275例行ACDF手术的患者，分为两组：PEEK组（n = 213）和Tri-C组（n = 62）。两组术后颈部和手臂疼痛以及NDI均有改善。比较Tri-C组和PEEK组时，在3个月或12个月时颈部或手臂疼痛或NDI的变化方面未观察到显著差异。此外，90天再入院率、90天再次手术率和围手术期并发症发生率也无差异。回归分析显示，Tri-C组与PEEK组相比并非任何结局的显著预测因素。
我们的结果表明，在ACDF手术中使用多孔钛Tri-C椎间融合器，在PROs、围手术期发病率和影像学参数方面是治疗颈椎DDD的有效方法。使用Tri-C椎间融合器进行ACDF手术的患者与使用PEEK椎间融合器的患者在任何临床结局上均未观察到显著差异。
III级。
