| Home | Magazines | Editorial Board | Instruction | Subscribe Guide | Archive | Advertising | Template | Guestbook | Help |
| LI Yuwei,WANG Haijiao,CUI Wei.Comparison of the efficacy of ACDF in the treatment of cervical spondylotic myelopathy using 3D printed intervertebral fusion cage and Polyether-ether-ketone(PEEK) intervertebral fusion cage[J].Chinese Journal of Spine and Spinal Cord,2021,31(1):16-24. |
| Comparison of the efficacy of ACDF in the treatment of cervical spondylotic myelopathy using 3D printed intervertebral fusion cage and Polyether-ether-ketone(PEEK) intervertebral fusion cage |
| Received:July 15, 2020 Revised:October 24, 2020 |
| English Keywords:Cervical spondylotic myelopathy Interbody fusion cage Polyether-ether-ketone 3D printing |
| Fund: |
|
| Hits: 2861 |
| Download times: 2463 |
| English Abstract: |
| 【Abstract】 Objectives: To compare the efficacy of 3D-printed interbody fusion cage and PEEK cage in the treatment of cervical spondylotic myelopathy(CSM). Methods: From May 2017 to March 2019, 71 patients suffered from CSM were randomly divided into observation group(35 with anterior cervical discectomy and interbody fusion with 3D-printed intervertebral cage) and the control group(36 with anterior cervical discectomy interbody fusion with PEEK cage). There were 26 males and 9 females in the observation group, with an average age of 46.4±4.9 years and a course of disease of 2.49±0.24 years. There were 23 males and 13 females in the control, with an average age of 46.1±4.3 years and a course of disease of 2.53±0.21 years. There was no statistically significant difference in preoperative data between the two groups(P>0.05). All of them completed the operation successfully, and the follow-up time was 12-23 months. 8 patients(3 in the observation group and 5 in the control) showed dysphagia after the operation, however, the symptoms disappeared after 1-2 weeks. JOA score and X-ray were performed before surgery, 3 months postoperatively, and at the final follow-up. The vertebral body height and Cobb Angle of the fusion segment were measured on the X-ray to observe the bone graft fusion. T-test, χ2 test and ANOVA were used for comparison between the two groups, P<0.05 was considered statistically significant. Results: No plate and screw fracture or displacement occurred in both groups, and bone healing was observed at 12 months of follow-up. There were no statistically significant differences between the observation group and control group in operation time(94.6±18.0min vs 89.2±18.5min), intraoperative blood loss(117.8±41.9ml vs 127.5±39.0ml), and hospital stay (10.0±2.2d vs 10.3±2.5d), respectively(P＞0.05). At final follow-up, the JOA score of the observation group was increased from 9.3±1.7 preoperatively to 14.5±1.6 after 12 months, with the improvement rate of 67.5%, while that in the control was increased from 8.16±2.8 preoperatively to 13.3±1.5 after 12 months, with the improvement rate of 58.1%. There was no significant difference in improvement rates between the two groups(t=1.292, P=0.200). The height of the vertebral body in single segment case(19 cases) was 31.21±0.94mm before surgery, 34.01±1.09mm three months after operation, and 33.02±1.32mm at final follow-up, while the height of the vertebral body in double segment case(16 cases) was 49.25±1.13mm, 53.75±1.34mm three months after the operation, and 51.96±1.04mm at final follow-up in observation group. Nevertheless, in the control, the height of the vertebral body in single segment case (20 cases) was 31.45±1.00mm before surgery, 33.21±1.00mm three months after surgery, and 31.28±1.28mm at final follow-up, while that in double segment case(16 cases) was 49.55±2.13mm before the operation, 52.45±1.27mm three months after the operation, and 50.72±1.36mm at final follow-up. Three months after surgery and at final follow-up, no matter single or double fusion segments, the height and Cobb angle were bigger in the observation group than in the control, and the differences were statistically significant(P<0.05). The fusion segment vertebral body height and Cobb angle in the observation group were improved compared with those before surgery, and the differences were statistically significant(P<0.05). 4 of 51 cages in observation group sank at final follow-up(2 single segmental cases, 1 double segmental) with prosthesis sedimentation rate 7.8%, while 16 of 52 cages in the control(8 single segmental cases, 4 double segmental) settling with prosthesis subsidence rate 30.8%, and the difference between the two groups was statistically significant(P<0.05). Conclusions: The stability of cervical can be reconstructed by both methods, and the fusion rate of intervertebral fusion is good. Compared with PEEK, 3D-printed intervertebral fusion cage has shorter operation time and lower prosthesissubsidence rate. Therefore, 3D-printed intervertebral fusion cage may be a better surgical method for CSM. |
| View Full Text View/Add Comment Download reader |
| Close |
|
|
|
|
|