Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up
Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up
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DOI：
10.1007/s00586-013-2772-y
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发表时间：
2013-07-01
影响因子：
2.8
通讯作者：
Chen, Deyu
中科院分区：
文献类型：
--
作者：
Chen, Yu;Wang, Xinwei;Chen, Deyu
颈椎前路椎间盘切除融合术（ACDF）结合钛或聚醚醚酮（PEEK）椎间融合器重建广泛应用于脊髓型颈椎病（CSM）的治疗。本研究旨在比较钛和PEEK椎间融合器治疗多节段CSM的结局。2002年11月至2004年12月期间，共80例3节段CSM患者按1：1的比例随机分配至钛组和PEEK组。随访时间86 ~ 116个月，平均99.7个月。比较钛合金组和PEEK组的临床和影像学结果，最终随访时，PEEK组的临床结局包括乔亚评分、NDI评分和临床结局的优良率均优于钛合金组。在钛组中观察到更多的Cobb角和椎间高度丢失，导致钛组的放射学参数在最终随访时劣于PEEK组。钛和PEEK组的融合器下沉率分别为34.5%和5.4%。末次随访时，两组患者均观察到融合。钛合金组有2例患者出现融合器脱位，无临床症状，在多节段CSM的手术治疗中，PEEK融合器在维持椎间高度和颈椎前凸方面上级钛合金融合器，长期随访的临床结局更好。
Anterior cervical discectomy and fusion (ACDF) with titanium- or polyetheretherketone (PEEK)-cage reconstruction is widely used in the treatment of cervical spondylotic myelopathy (CSM). This study was to compare outcomes of titanium and PEEK cages in the treatment of multilevel CSM.Between November 2002 and December 2004, a total of 80 patients with 3-level CSM were randomized in a 1:1 ratio to titanium group and PEEK group. The overall follow-up period of the patients ranged from 86 to 116 months (average 99.7 months). Clinical and radiological results were compared between titanium group and PEEK group.At the final follow-up, the clinical outcomes including JOA score, NDI score, and the excellent and good rates of clinical outcomes in the PEEK group were better than those in the titanium group. More loss of the Cobb angles and the intervertebral height was observed in the titanium group, resulting in the radiological parameters in the titanium group becoming inferior to the PEEK group at the final follow-up. Cage subsidence rates were 34.5 and 5.4 % in the titanium and PEEK groups, respectively. Fusion was observed in all patients of two groups at the final follow-up. Two patients presented with cage dislocation without clinical symptoms in the titanium group.In surgical treatment of multilevel CSM, PEEK cage is superior to titanium cage in maintenance of intervertebral height and cervical lordosis, resulting in better clinical outcomes in the long-term follow-up.