Clinical outcomes of poly ether ether ketone rods and pedicle screw system for lumbar degenerative diseases / 中华骨科杂志

ABSTRACT

Objective To explore the reliability and validity of poly ether ether ketone (PEEK) rods and pedicle screw system for lumbar degenerative diseases.Methods Sixty-three patients,including 23 men and 40 women with the mean age of 56.2±5.1 years (range,35-75 years),treated by PEEK rods pedicle screw system from September 2012 to March 2013 were retrospectively recruited.Fusion procedure were performed in 10 patients,with 2 cases at L3,4,5 cases at L4,5,3 cases at L5S1; nonfusion procedure were performed in 17 patients,with 4 cases at L3,4,10 cases at L4,5,3 cases at L5S1; hybrid procedure were performed in 36 patients,with 22 case fusion at L4,5 and nonfusion at L3,4,with 2 cases fusion at L3,4 and nonfusion at L4,5,with 12 cases fusion at L5S1 and nonfusion at L4,5.Clinical effects were evaluated via Japanese Orthopedics Association (JOA) score and Oswestry disfunction index (ODI) at 3 months,6 months and 24 months postoperatively.Disc heights were measured by disc height index on lateral lumbar radiograph.Range of motion (ROM) was measured by extension-flexion lumbar X-ray.Three-dimensional CT reconstruction was achieved to observe the integrity of PEEK rods at the final follow-up.Results The mean follow-up were 23.4±3.3 months.The mean operation time were 110±17 min in the fusion group,98±22 min in the non-fusion group and 121±25 min in the hybrid group.The mean blood loss were 270±85 ml in the fusion group,255±72 ml in the non-fusion group and 316±80 ml in the hybrid group.The JOA score improved from 10.5±2.6 preoperatively to 24.0±3.1 at the final follow-up in the fusion group,from 10.3±2.2 to 24.3±3.4 in the non-fusion group and from 11.1±2.3 to 23.9±3.3 in the hybrid group (P＜0.05).The ODI decreased from 51.8％±10.3％ preoperatively to 14.1％±3.7％ at the final follow-up in the fusion group,from 52.2％±11.1％ to 13.2％±3.2％ in the non-fusion group and from 53.4％±9.2％ to 13.8％±2.5％ in the hybrid group.There was no significantly statistical difference in the disc height index at 3 months,6 months and 24 months postoperatively compared with that at preoperative.The ROM decreased from 8.8°±1.8° preoperatively to 2.2°±0.3° at the final follow-up (P＜0.05).One case demonstrated cage migration at one month follow-up,bony fusion in situ at 3 months follow-up,and the patient had no related symptoms during the follow-up.No screw loosening or breakage and rods breakage was observed during the follow-up.Conclusion PEEK rods and pedicle screw system for lumbar degenerative diseases by fusion,non-fusion and hybrid procedure can achieve considerable clinical outcome with low complication rate.