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KMID : 0361620110460050364
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Journal of the Korean Orthopaedic Association
2011 Volume.46 No. 5 p.364 ~ p.371
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Comparison According to Fusion Level in ACDF Using PEEK Cage Alone for Degenerative Cervical Disease
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Song Kyung-Jin
Lee Kwang-Bok
Kim Ki-Bum
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Abstract
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Purpose:This study examined the clinical efficacy of an anterior cervical discectomy and fusion (ACDF) with PEEK (polyetheretherkiltone) cage alone with regard to the clinical and radiological outcomes, as well as the risk factors for the cage subsidence.
Materials and Methods : A total of 128 patients who underwent group A (1-level, n=48), group B (2-levels, n=57), group C (3-levels, n=23) ACDF using a PEEK cage alone were enrolled in this study. The fusion rate, segmental kyphosis were assessed by radiographs. The clinical outcomes were assessed using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). The risk factors for cage subsidence were analyzed according to the difference in incidence between the subsidence group and non-subsidence group.
Results:Solid fusion was achieved in 93.8%(45/48), 71.9%(41/57) and 69.6%(15/23) of subjects in group A, B and C, respectively. Segmental kyphosis was observed in 22.9%(11/48), 43.9%(25/57) and 47.8%(11/23) of subjects in group A B and C, respectively. The VAS scores changed from 7.79±1.01 in group A 7.74±1.09 in group B, 7.91±0.79 in group C preoperatively to 4.23±1.29 in group A, 5.25±1.34 in group B and 5.35±1.07 in group C at the last follow up. In addition, the NDI was also improved at the last follow up. The VAS score and NDI at the last follow up were similar in the subsidence and non-subsidence group. The 3-level ACDF(p=0.05), osteoporosis(p=0.01), and old age (p=0.01) were the risk factors for cage subsidence.
Conclusion:Only 1 level ACDF with PEEK cage alone was similar in clinical and radiologic (solid fusion rate, local kyphosis) outcomes compared to ACDF with published other modalities. Old age, 3 fusion level, osteoporosis, and C6-7 fusion were risk factors for the cage subsidence with higher complication rates.
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KEYWORD
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anterior cervical discectomy and fusion, cage alone, cage subsidence
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