Early Fusion Status after Posterior Lumbar Interbody Fusion with Cortical Bone Trajectory Screw Fixation: A Comparison of Titanium-Coated Polyetheretherketone Cages and Carbon Polyetheretherketone Cages
Asian Spine Journal
;
: 248-253, 2019.
Article
in English
| WPRIM
| ID: wpr-762929
ABSTRACT
STUDY DESIGN:
Retrospective cohort study.PURPOSE:
We recently reported that when compared to posterior lumbar interbody fusion (PLIF) using traditional pedicle screw fixation, PLIF with cortical bone trajectory screw fixation (CBT-PLIF) provided favorable clinical outcomes and reduced the incidence of symptomatic adjacent segment pathology, but resulted in relatively lower fusion rates. Since titanium-coated polyetheretherketone (PEEK) cages (TP) could improve and accelerate fusion status after CBT-PLIF, early fusion status was compared between CBT-PLIF using TP and carbon PEEK cages (CP). OVERVIEW OF LITERATURE A systematic review demonstrated that clinical studies at this early stage show similar fusion rates for TP compared to PEEK cages.METHODS:
We studied 36 consecutive patients undergoing CBT-PLIF with TP (TP group) and 92 undergoing CBT-PLIF with CP (CP group). On multiplanar reconstruction computed tomography (MPR-CT) at 6 months postoperatively, vertebral endplate cysts (cyst signs) were evaluated and classified as diffuse or local cysts. Early fusion status was assessed by dynamic plain radiographs and MPR-CT at 1 year postoperatively.RESULTS:
The incidences of cyst signs, diffuse cysts, and early fusion rate in the TP and CP groups were 38.9% and 66.3% (p0.05), respectively. Combining the two groups, 22 of 36 patients with diffuse cysts had nonunion at 1-year follow-up, compared to only three of 92 patients with local cysts or without cyst signs (p<0.01).CONCLUSIONS:
Despite having fewer patients with endplate cysts at 6 months (a known risk factor for nonunion), the TP group had the same fusion rate as the CP group at 1-year follow-up. Thus, TP did not accelerate the fusion process after CBT-PLIF.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Carbon
/
Incidence
/
Retrospective Studies
/
Risk Factors
/
Cohort Studies
/
Follow-Up Studies
/
Pedicle Screws
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Asian Spine Journal
Year:
2019
Type:
Article
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