Preliminary experience using a polyetheretherketone (PEEK) cage in the treatment of cervical disc disease
Preliminary experience using a polyetheretherketone (PEEK) cage in the treatment of cervical disc disease
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DOI：
10.1097/00006123-200212000-00003
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发表时间：
2002-12-01
期刊：
影响因子：
4.8
通讯作者：
Sheu, PC
中科院分区：
文献类型：
--
作者：
Cho, DY;Liau, WR;Sheu, PC
目的：我们调查了一种新材料，聚醚醚酮（PEEK），在用于执行颈椎融合矫正颈椎后凸畸形的脊柱融合器的有效性。方法：共80例各种颈椎疾病患者分为两组。A组患者（40例患者）接受了显微椎间盘切除术和PEEK椎间融合器融合术，B组患者（40例患者）接受了显微椎间盘切除术和自体髂嵴移植物（AICG）融合术。我们根据X线片评估患者的颈椎前凸、椎间孔高度、椎间孔横截面积和融合状态。根据Prolo量表评估患者的神经和功能结局。结果：在接受脊柱融合术的患者中使用PEEK椎间融合器可能会增加颈椎前凸（平均值为2.33 +/- 3.00 mm; P = 0.03），而AICG融合可能不会（平均值为-0.84 +/- 6.69 mm; P = 0.49）。发现PEEK椎间融合器的使用增加了椎间孔的高度（平均值，2.54 ± 1.40 mm; P = 0.00），并增加了其横截面积2（平均值，40.36 ± 23.53 mm; P = 0.00）。术后仅PEEK组的椎间孔高度增加。术后两组椎间孔的横截面积均增加。采用PEEK椎间融合器进行融合术的患者的并发症发生率低于采用AICG融合术进行融合的患者（2.50% vs 17.50%; P = 0.03）。两组的融合率均令人满意（100 vs 93.1%）。PEEK组患者的术后Prolo量表评分在统计学上更好（8.50 +/- 1.49 vs. 7.17 +/- 2.13; P = 0.00），PEEK组比AICG组更多的患者获得了极好的结局（66.63 vs. 28.57%; P 0.00）。由于PEEK在X射线上是射线可透的，并且在磁共振成像扫描上很少看到伪影，因此它比自体髂嵴供体材料更适合用于术后影像学评估。结论：PEEK椎间融合器提供了牢固的融合，增加了颈椎前凸，并增加了椎间孔的高度和横截面积。与使用该融合器相关的并发症很少，功能和神经结局令人满意。它还有助于术后X线和磁共振成像评估。因此，PEEK椎间融合器是颈椎间盘疾病患者AICG融合的良好替代品。
OBJECTIVE: We investigated the effectiveness of a new material, polyetheretherketone (PEEK), in a spinal cage used in performing cervical spinal fusion for the correction of cervical kyphosis.METHODS: A total of 80 patients with various cervical diseases were divided into two groups. Patients in Group A (40 patients) underwent microdiscectomy and PEEK cage fusion, and patients in Group B (40 patients) were treated with microdisectomy and autogenous iliac crest graft (AICG) fusion. We evaluated the patients for cervical lordosis, the height of the foramina, the cross sectional area of the foramina, and fusion status on the basis of x-rays. The patients' neurological and functional outcomes were assessed on the basis of the Prolo scale. Magnetic resonance imaging was also performed for spinal cord evaluation.RESULTS: The use of the PEEK cage in patients who undergo spinal fusion may increase cervical lorclosis (mean, 2.33 +/- 3.00 mm; P = 0.03), whereas AICG fusion may not (mean, -0.84 +/- 6.69 mm; P = 0.49). The use of the PEEK cage was found to increase the height of the foramina (mean, 2.54 +/- 1.40 mm; P = 0.00) and increase its cross sectional area 2 (mean, 40.36 +/- 23.53 mm; P = 0.00). The height of the foramina increased only in the PEEK group postoperatively. The cross sectional area of the foramina increased in both groups postoperatively. The complication rate in patients who underwent fusion proceclures with the PEEK cage was less than that in patients who underwent fusion with AICG fusion (2.50 versus 17.50%; P = 0.03). Both groups had a satisfactory fusion rate (100 versus 93.1%). The patients' postoperative Prolo scale scores were statistically better in the PEEK group (8.50 +/- 1.49 versus 7.17 +/- 2.13; P = 0.00), and more patients in the PEEK group than in the AICG group achieved excellent outcomes (66.63 versus 28.57%; P 0.00). Because PEEK is radiotransparent on x-rays and few artifacts are seen on magnetic resonance imaging scans, it is better suited than autogenous iliac crest donor material for postoperative radiographic evaluation.CONCLUSION: The PEEK cage provides solid fusion, increased cervical lordosis, and increased height and cross sectional area of the foramina. There are few complications associated with the use of this cage, and the functional and neurological outcomes are satisfactory. It also facilitates postoperative x-ray and magnetic resonance imaging evaluation.. The PEEK cage is therefore a good substitute for AICG fusion in patients with cervical disc disease.