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; Lee, Jung-Kil; Jang, Jae-Won; Park, Hyun-Woong; Hur, Hyuk

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자료유형: 학술저널

저자정보: 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)

저널정보: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제60권 제2호

발행연도: 2017.1

수록면: 211 - 219 (9page)

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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.

#ACDF #DBM #Iliac autograft #PEEK cage #Subaxial cervical spine injury

참고문헌 (30)

참고문헌 신청

Aebi M / 2009 / Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures / Eur Spine J 19(Suppl 1):S33~S39

Bishop RC / 1996 / Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate : a prospective comparative analysis / J Neurosurg 85:206~210

Bohlman HH / 1979 / Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature / J Bone Joint Surg Am 61:1119~1142

Bracken MB / 1990 / A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the second national acute spinal cord injury study / N Engl J Med 322:1405~1411

Cauthen JC / 1998 / Outcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients / Spine 23:188~192

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