Abstrait

The application of polyetheretherketone cage for lumbar fusion and the pedicle screw-based internal fixation in senile lumbar degenerative diseases

Ping Wang, Huiping Zhang, Litong Liu, Chunlei Wu, Hao Wang

Objective: Our objective is to analyse the clinical effect and safety of Polyetheretherketone (PEEK) cage for lumbar fusion and the pedicle screw-based internal fixation in senile lumbar degenerative diseases, and further discuss the value of clinical application.

Methods: 172 patients with senile lumber degenerative diseases admitted in our hospital during March, 2013-March, 2016 were selected, which were divided into the observation group and control group according to the random number method with 86 cases in either group. All the patients received lumbar inter-body fusion and pedicle screw-based internal fixation, in the observation group the material for inter-body infusion was PEEK and in the control group was titanium alloy. The surgery condition and complications in two groups were compared, and Japanese Orthopaedic Association (JOA) scores, Oswestry disability index (ODI) scores, ranges of joint motion, disc space heights and fusion rates were also observed to explore the applicable value of PEEK cage for lumbar fusion in senile lumbar degenerative diseases.

Results: The operation time and intraoperative blood loss in two groups were not statistically different (P>0.05); there was no infection or nerve root injury and no looseness or breakage of internal fixation during follow-up, the bone graft recovered well. Compared with before surgery, the JOA scores were increased and ODI scores were decreased at 3 and 6 months after surgery, which were statistically significant (P<0.05), JOA and ODI scores between two groups at the same stages after surgery were not statistically different (P>0.05). Compared to before surgery, the motion ranges of instrumented segments in two groups were both decreased, and the motion ranges and the disc space heights of adjacent segments were both increased. After 6 months, the motion ranges of instrumented segments and adjacent segments and the disc space heights in the observation group were higher than the control group, which were statistically significant (P<0.05); The fusion rates of bone graft between two groups at the same stages after surgery were not statistically different (P>0.05).

Conclusion: The clinical effects and safety of PEEK for lumbar fusion and the pedicle screw-based internal fixation in senile lumbar degenerative diseases are good. PEEK cage can better improve the range of joint motion and disc space height compared with titanium alloy cage, which is worthy of further application.