[Clinical and Radiological Results after Anterior Cervical Corpectomy with Cage Fusion – a Retrospective Comparison of PEEK vs. Titanium Cages].
Z Orthop Unfall. 2017 Apr;155(2):201-208
Authors: Schulz C, Mauer UM, Mathieu R
Background Anterior cervical corpectomy and fusion (ACCF) has change into an ordinary process for sufferers with spondylotic myelopathy as a result of multisegmental stenosis of the cervical canal. Beside the fusion method utilizing autogenous bone grafts, artificial cages have been more and more used in recent times. Printed data on the scientific and radiological outcomes of various cage supplies for ACCF continues to be restricted. The research offered right here is the biggest collection to this point reporting scientific and radiological outcomes and complication charges after one- to three-level ACCF utilizing structural polyetheretherketone (PEEK) or titanium cages augmented by anterior plate-screw osteosynthesis. Supplies and Strategies Retrospective comparative research on 126 sufferers after cage ACCF utilizing modular PEEK (n?=?101) or distractable titanium (n?=?25) cages with a minimal follow-up of 6 months. The numbers of failures and implant-related surgical revisions have been decided. The speed of subsidence and fusion and the course of lordotic alignment (segmental and regional Cobb’s angles) have been analysed. Neck Incapacity Index (NDI) and European Myelopathy Rating (EMS) have been assessed. Outcomes Considerably larger variety of screw and cage problems have been detected within the titanium cage group (36 vs. 7.9?% and 64 vs. 36.6?%, respectively). Non-significant pattern to a better fee of implant associated revision fee within the titanium cage group (16 vs. 2.97?%). Considerably larger fee of grade I or II fusion within the PEEK cage group after 6 months (82 vs. 52?%). NDI, EMS and lordotic alignment improved considerably in each teams. There have been neither important variations between the 2 teams nor important correlations between these clinico-radiological parameters and the cage materials. Partial correlations carried out with management of parameters displaying inhomogenous distribution (affected person age, fusion distance, fee of multilevel corpectomy and the speed of intraoperative segmental overdistraction) confirmed no important correlations for any of the scientific or radiological end result parameters and the problems or revisions to the cage materials. Conclusion Cages are a protected and efficient different to autogenous bone graft for ACCF. A big enchancment in scientific and radiological parameters might be achieved with each titanium and PEEK implants. Vital variations between the 2 cage materials teams or important correlations of clinico-radiological end result and cage materials weren’t confirmed. Furthermore there isn’t any proof within the literature for scientific benefits of 1 particular cage materials, to this point. Subsequently additional potential randomised analysis of various fusion strategies in ACCF continues to be obligatory.
PMID: 28073140 [PubMed – indexed for MEDLINE]