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KMID : 1001920080440060370
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Journal of Korean Neurosurgical Society
2008 Volume.44 No. 6 p.370 ~ p.374
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Radiologic Assessment of Subsidence in Stand-Alone Cervical Polyetheretherketone (PEEK) Cage
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Ha Sung-Kon
Park Jung-Yul
Kim Se-Hoon
Lim Dong-Jun
Kim Sang-Dae
Lee Sang-Kook
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Abstract
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Objective: Aim of study was to find a proper method for assessing subsidence using a radiologic measurement following anterior cervical discectomy and fusion (ACDF) with stand-alone polyetheretherketone (PEEK), Solis™ cage.
Methods: Forty-two patients who underwent ACDF with Solis™ cage were selected. With a minimum follow-up of 6 months, the retrospective investigation was conducted for 37 levels in 32 patients. Mean follow-up period was 18.9 months. Total intervertebral height (TIH) of two fused vertebral bodies was measured on digital radiographs with built-in software. Degree of subsidence (ΔTIH) was reflected by the difference between the immediate postoperative and follow-up TIH. Change of postoperative disc space height (CT-MRΔTIH) was reflected by the difference between TIH of the preoperative mid-sagittal 2D CT and that of the preoperative mid-sagittal T1-weighted MRI.
Results: Compared to preoperative findings, postoperative disc height was increased in all cases and subsidence was observed only in 3 cases. For comparison of subsidence and non-subsidence group, TIH and CT-MRΔTIH of each group were analyzed. There was no statistically significant difference in TIH and CT-MRΔTIH between each group at 4 and 8 weeks, but a difference was observed at the last follow-up TIH (p=0.0497).
Conclusion: ACDF with Solis™ cage was associated with relatively good radiologic long-term results. Fusion was achieved in 94.5% and subsidence occurred in 8.1% by the radiologic assessment. Statistical analysis reveals that the subsidence seen later than 8 weeks after surgery and the development of subsidence does not correlate statistically with the change of the postoperative disc space height.
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KEYWORD
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Cervical PEEK cage, Radiologic assessment, subsidence, Fusion rate, Anterior cervical discectomy and fusion
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