Fidji椎间融合器治疗颈椎间盘突出症近期疗效研究

The Observation of Short Term Effect of Fidji Cage Treating CDH

目的对使用Fidjicag(e聚醚醚酮PEEK材料)治疗颈椎间盘突出症患者的近期疗效进行回顾性分析。方法对我院最初的11例(14节段)颈椎间盘突出症患者使用Fidjicage进行颈前路植骨融合手术进行回顾研究。随访时间为12～30个月(平均18个月),术后3、6、12和24个月拍摄颈椎的正侧位片。对椎间隙的前高度(ADH)、椎间隙的后高度(PDH)、椎间高度比(IBHR)以及椎体间角(IBA)进行测量和比较。融合的效果通过椎间隙骨小梁的连续性来评价。收集到数据的组间差异通过t检验进行比较。结果术后3个月时除1例(1节段)以外所有的病例都得到了椎间融合,术后6个月时,所有病例都得到了椎间融合。术后的ADH、PDH、IBHR和IBA较各自术前明显增加,而且在随访终点得到了较好的保持。在随访的终点未发现有椎间融合器的移位或者脱落的情况。结论 Fidjicage可以提供高融合率、低下沉率、即刻稳定性,影像学方法评价后认为Fidjicage的物理属性与设计较为合理,可以为颈椎间盘突出症的患者提供较好的近期疗效。

Objective Radiological review of cases performed at our institution with a novel cage Fidji cage（PEEK）.Methods A retrospective review of the first 14 consecutive cases of single-level anterior cervical interbody fusion using the Fidji cage（PEEK material） for cervical spondylotic radiculopathy or myelopathy was performed.The follow-up ranged from 12 to 30months（average 18 months）.Anteroposterior and lateral radiographs were taken immediately after the surgery and at intervals of 3,6,12,and 24 months after surgery.Anterior disc height（ADH）,posterior disc height（PDH）,interbody height ratio（IBHR）,and interbody angle（IBA） were measured on the lateral radiographs and compared.Fusion was assessed by examining for trabecular continuity,bridging of bone across the disc space,and sclerosis at the vertebral end plates on both sides.The parameters assessed were time for fusion,subsidence,segmental sagittal alignment of the operated segment,and presence/absence of migration of the cage.Data were analyzed using the t test.Results Fusion was evident at 3-6 months postsurgery in all cases except one.At the last follow-up,fusion was maintained in all cases.The immediate postoperative ADH,PDH,IBHR and IBA were significantly greater than the respective preoperative values and was maintained at the last follow-up though there was a significant amount of subsidence when the follow-up radiographs were compared with the immediate postoperative X-rays.Conclusion The high fusion rate,low subsidence,stability provided by the cage,and facilitation of radiological assessment are the result of the physical properties of the PEEK material as well as the design of the cage.