A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up.

Autor: Chen Y; Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China., Lü G; Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China., Wang B; Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China., Li L; Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China., Kuang L; Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China. leikuangcs@sohu.com.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2016 Jul; Vol. 25 (7), pp. 2255-62. Date of Electronic Publication: 2016 Feb 23.
DOI: 10.1007/s00586-016-4391-x
Abstrakt: Purpose: To evaluate the clinical efficacy and radiological outcomes of anterior cervical discectomy and fusion (ACDF) using self-locking polyetheretherketone (PEEK) cages for treatment of three-level cervical degenerative spondylopathy.
Methods: Twenty-eight patients underwent three-level ACDF using self-locking stand-alone PEEK cages (group A), and 26 patients underwent three-level ACDF using cages and plate fixation (group B) were reviewed retrospectively. Clinical efficacy was evaluated by pre- and post-operative Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI). The operation time, blood loss, surgical results according to Odom's criteria and post-operative dysphagia status were also recorded. Radiological outcomes including fusion, cervical Cobb's lordosis, fused segment angle, disc height, and cage subsidence were assessed.
Results: Clinical outcome measures such as dysphagia and fusion rate and the results of surgery evaluated according to Odom's criteria were not statistically significant (P > 0.05) between groups. The operation time was shorter and blood loss was less in group A (P < 0.05). The NDI and JOA scores showed significant improvements in both groups after surgery at each time point (P < 0.05) with no significant difference between groups (P > 0.05). Post-operative cage subsidence, the loss of disc height, cervical lordosis and the fused segment angle were relatively higher in group A than group B (P < 0.05).
Conclusions: ACDF using self-locking stand-alone cages showed similar clinical results as compared to ACDF using cages and plate fixation for the treatment of three-level cervical degenerative spondylopathy. However, potential long-term problems such as cage subsidence, loss of cervical lordosis and fused segment angle post-operatively were shown to be associated with patients who underwent ACDF using self-locking stand-alone cages.
Databáze: MEDLINE
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