Titanium cageversuspolyetheretherketone cage in posterior lumbar interbody fusion with pedicle screw fixation / 中国组织工程研究

ABSTRACT

BACKGROUND:Due to the higher modulus of elasticity, titanium cages are prone to have the folowing shortcomings adjacent vertebral sinking and delayed fusion resulting from stress shielding; therefore, in recent years, it has been gradualy replaced by polyetheretherketone cages. OBJECTIVE:To compare the clinical and radiographic outcomes of patients undergoing posterior lumbar interbody fusion with pedicle screw fixation in which either a polyetheretherketone cage or a titanium cage was implanted. METHODS: The pre- and postoperative data of 104 patients who underwent single-level posterior lumbar interbody fusion were colected and analyzed, including 57 males and 47 females, aged (41.2±10.5) years. The 58 of 104 patients received the titanium cage and the remaining 52 patients received the polyetheretherketone cage. Visual analog scale scores and Japanese Orthopaedic Association Scores of the lumbar and lower limbs were recorded at 24 hours of postoperative folow-up; CT scan was used to detect bone fusion and cage subsidence. RESULTS AND CONCLUSION:After 12 and 24 months of folow-up, the visual analog scale scores and Japanese Orthopaedic Association Scores of the lumbar and lower limbs were al improved in the two groups compared with the previous (P < 0.05), but there was no difference between the two groups. At 12 and 24 months of folow-up, the fusion rates were 94% and 100% in the titanium cage group as wel as 74% and 84% in the polyetheretherketone cage group, respectively, and a significant difference was found between the two groups (P=0.012 andP=0.016). At 24 months of folow-up, the subsidence rate was 36% in the titanium cage group and 30% in the polyetheretherketone cage group, and there was no difference between the two groups. These findings indicate that the superiority of polyetheretherketone cages over titanium cages has not been demonstrated.