Journal of Korean Neurosurgical Society

  • 제60권2호
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  • Pages.211-219
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  • 2017
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Polyetheretherketone Cage with Demineralized Bone Matrix Can Replace Iliac Crest Autografts for Anterior Cervical Discectomy and Fusion in Subaxial Cervical Spine Injuries

  • Kim, Soo-Han (Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences) ;
  • Lee, Jung-Kil (Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences) ;
  • Jang, Jae-Won (Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences) ;
  • Park, Hyun-Woong (Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences) ;
  • Hur, Hyuk (Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences)
  • 투고 : 2016.03.06
  • 심사 : 2016.12.15
  • 발행 : 2017.03.01
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초록

Objective : This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM). Methods : From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2-7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade. Results : The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups. Conclusion : This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries.

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참고문헌

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피인용 문헌

  1. Outcomes of Anterior Cervical Fusion Using Polyetheretherketone Cage with Demineralized Bone Matrix and Plate for Management of Subaxial Cervical Spine Injuries vol.14, pp.2, 2017, https://doi.org/10.13004/kjnt.2018.14.2.123
  2. Clinical Efficacy of Cages in Anterior Cervical Fusion for Degenerative Cervical Disease vol.26, pp.4, 2019, https://doi.org/10.4184/jkss.2019.26.4.172
  3. Cages in ACDF are Associated With a Higher Nonunion Rate Than Allograft : A Stratified Comparative Analysis of 6130 Patients vol.44, pp.6, 2019, https://doi.org/10.1097/brs.0000000000002854
  4. Cage Subsidence after Surgery on the Anterior Part of the Subaxial Cervical Spine: a Monocentric Prospective Clinical Study with a 3-Year Follow-Up vol.26, pp.2, 2017, https://doi.org/10.21823/2311-2905-2020-26-2-139-147
  5. Structural Allograft Versus PEEK Implants in Anterior Cervical Discectomy and Fusion: A Systematic Review vol.10, pp.6, 2017, https://doi.org/10.1177/2192568219883256
  6. Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient vol.17, pp.4, 2017, https://doi.org/10.14245/ns.2040216.108
  7. Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review vol.11, pp.2, 2017, https://doi.org/10.1177/2192568220907574