Calek Anna-Katharina, Hochreiter Bettina, Buckland Aaron J
Melbourne Orthopaedic Group, Melbourne, VIC, Australia.
Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Global Spine J. 2025 Jun 1:21925682251344557. doi: 10.1177/21925682251344557.
Study DesignRetrospective study.ObjectiveTo determine the fusion rate in patients undergoing anterior lumbar interbody fusion (ALIF) and/or lateral lumbar interbody fusion (LLIF) with titanium cages.MethodsFusion at 1-year was assessed by computed tomography (CT) using Lenke-Bridwell classification. Flexion-extension lateral radiographs confirmed fusion if motion was <5° through the fused segment. Perioperative metrics including bone graft type, operative time, estimated blood loss, revisions within the first postoperative year, clinical outcome assessed by the Oswestry Disability Index (ODI).ResultsOne hundred patients with a total of 137 fusion levels with 3DPTi cages were identified. In this cohort, 75% underwent primary surgery and 25% had a previous surgery. At 1-year post-op, 97.1% of interbody levels were fused (Grade I) on CT, and all levels appeared fused on flexion-extension radiographs. Four patients (4%) required additional surgery within the first two years. No revisions were required for cage subsidence/migration, or pseudoarthrosis. Median ODI significantly improved from 39 at baseline to 10 at 1-year ( = .001).Conclusion3D-printed titanium cages for ALIF and LLIF result in excellent fusion rates at one year postoperatively without the use of rhBMP-2.
研究设计
回顾性研究。
目的
确定接受前路腰椎椎间融合术(ALIF)和/或侧路腰椎椎间融合术(LLIF)并使用钛笼的患者的融合率。
方法
使用Lenke-Bridwell分类法通过计算机断层扫描(CT)评估1年时的融合情况。如果融合节段的活动度<5°,则屈伸位侧位X线片可确认融合。围手术期指标包括骨移植类型、手术时间、估计失血量、术后第一年内的翻修情况,通过Oswestry功能障碍指数(ODI)评估临床结果。
结果
共确定了100例患者,使用3D打印钛笼进行了137个节段的融合。在该队列中,75%接受了初次手术,25%曾接受过手术。术后1年,CT显示97.1%的椎间融合节段达到融合(I级),屈伸位X线片显示所有节段均融合。4例患者(4%)在两年内需要再次手术。无需因钛笼下沉/移位或假关节进行翻修。ODI中位数从基线时的39显著改善至1年时的10(P = .001)。
结论
用于ALIF和LLIF的3D打印钛笼在术后1年可实现优异的融合率,无需使用重组人骨形态发生蛋白-2(rhBMP-2)。