n-HA/PA66与PEEK cage在颈前路椎间盘切除减压术后椎间隙重建的比较研究
刘显宏, 欧云生, 蒋电明, 权正学, 张乐, 陈鑫, 胡侦明
中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (6) : 687-692.
n-HA/PA66与PEEK cage在颈前路椎间盘切除减压术后椎间隙重建的比较研究
Initial curative effect comparision of ano-hydroxyapatite polyamide-66 cage and polyetheretherketone cage on anterior cervical intervertebral disc discectomy and fusion
目的 观察比较纳米羟基磷灰石/聚酰胺66颈椎融合器（n-HA/PA66 Cage）与聚醚醚酮颈椎融合器(PEEK Cage)在颈前椎间盘切除减压术后椎间隙植骨重建的初期疗效。 方法 回顾性分析2008年6月~2011年6月手术治疗资料完整的57例颈椎病患者，行颈前路椎间盘切除减压Cage植骨融合钛钉板系统内固定治疗，其中31例采用n-HA/PA66 cage, 26例采用PEEK cage 。术后随访包括影像学及临床疗效评价，影像学评价包括术前、术后正侧位片、动力位片观察植骨融合率、塌陷率、颈椎曲度及手术节段椎间隙高度情况；临床疗效采用Odom标准评定。 结果 n-HA/PA66组患者6月时获得97.7%植骨融合，PEEK组融合率100%，两组融合率无统计学差异（P＞0.05）；n-HA/PA66组术后颈椎丢失的角度为(2.06±1.77)°较PEEK组(2.39±1.56)°稍低，两组数据无统计学差异（P=0.384）；n-HA/PA66组与 PEEK组术后平均椎间隙丢失高度无统计学意义（0.46±0.52 mm，0.41±0.18 mm，P=0.599），其中n-HA/PA66组出现1例患者1个节段塌陷，塌陷率2.3%，与PEEK组塌陷率（0%）比较无统计学差异（P=0.372）；PEEK组获得81%临床优良率对比n-HA/PA66组77%的优良率无统计学差异（P=0.757）。 结论 颈前路椎间盘切除减压后，n-HA/PA66与PEEK cage椎间隙植骨融合并内固定治疗颈椎病的初期临床疗效与影像学结果均较好且相似。
Objective To evaluate the preliminary efficacy using polyetheretherketone cage (PEEK Cage) and Nano-hydroxyapatite polyamide/66 cage (n-HA/PA66 Cage) composites for reconstruction following anterior cervical intervertebral discectomy and fusion (ACDF) in cervical spondylosis. Methods We performed a retrospective study of patients (57 cases, 31cases in n-HA/PA66 group, 26 cases in PEEK group) with cervical spondylopathy who underwent ACDF by two different cages between June 2008 and June 2011. Cervical pathologies included cervial spondylotic myelopathy and cervical radiculopathy. All patients were assessed clinically and radiologically. Clinical outcome was evaluated using Odom's criteria, radiology result included subsidence of the cages, the angle of cervical lordosis, the fusion rate and interspace height. Results There was no significant difference of fusion rate between both groups （97.7% vs. 100% , P＞0.05 ）. As well the loss of cervical lordosis (2.06±1.77° vs. 2.39±1.56°, P=0.384). The mean loss of interspace height (0.46±0.52 mm) in n-HA/PA66 group was a little higher than that (0.41±0.18 mm) in PEEK group, without significant difference in both groups（P=0.599）. An interspace collapse of 3mm or greater was observed in 2.3% in n-HA/PA 66 cage group, compared with zero one in the PEEK group(P=0.372). The PEEK group achieved an 81% rate of successful clinical outcomes, compared with 77% in the n-HA/PA 66 group (P=0.757). Conclusions The n-HA/PA66 cage is as good as PEEK cage in preliminary outcomes for anterior cervical intervertebral disc discectomy and fusion.
/ 纳米羟基磷灰石 / 聚醚醚酮 / 椎间融合器 / 颈椎前路融合术
Nano-hydroxyapatite polyamide/66(n-HA/PA 66) / Polyetheretherketone (PEEK ) / Cage / Anterior cervical intervertebral discectomy and fusion (ACDF)
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国家高新技术研究发展（“863”）（2002AA326020）；重庆市科学技术委员会科技攻关项目（cstc2012gg-yyjs10018）
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