RESULTS OF TREATMENT OF CERVICAL DISCOPATHY WITH PEEK INTERBODY CAGES AT THREE LEVELS WITHOUT PLATE FIXATION

ABSTRACT Objective: To present the results of treatment of patients with cervical discopathy by anterior cervical approach, discectomy and placement of a PEEK interbody cage without anterior plate fixation. Methods: Retrospective, cross-sectional study from March 2013 to March 2015. Sixteen patients with radiculopathy or clinical signs of myelopathy were included; all patients underwent cervical surgery through anterior approach, discectomy, and placement of PEEK cages on three levels. Decompression levels were determined according to the correlation between preoperative radiological and clinical findings. Results: Sixteen patients predominantly male were included, with mean age of 50 years at the onset of the condition. Ten patients had involvement of C4-C5, C5-C6, C6-C7 levels, and six patients C3-C4, C4-C5 and C5-C6. Fourteen patients had cervicobrachialgia and two myelopathy. The preoperative visual analog scale average was 8/10 and the average postoperative value at 6 months was 3/10. At 6 months, there was no radiological evidence of recurrence. One patient had non-fatal complications. Conclusions: The treatment of cervical discopathy by anterior approach with interbody fusion with PEEK cage on three levels, with no plate fixation seemed to be safe and effective with better long-term results in terms of pain and myelopathy. The clinical results compare favorably with other similar series and, most importantly, the complications associated with anterior fixation plate are avoided.

摘要 目的：报告采用颈前路入路、椎间盘切除术并植入聚醚醚酮（PEEK）椎间融合器且不使用前路钢板固定的方式治疗颈椎椎间盘病患者的临床疗效。方法：本研究为2013年3月至2015年3月期间开展的回顾性横断面研究。纳入16例存在神经根病或脊髓病临床体征的患者；所有患者均通过颈前路入路接受手术，行椎间盘切除术并在3个节段植入PEEK椎间融合器。减压节段根据术前影像学检查结果与临床表现的相关性确定。结果：纳入的16例患者以男性为主，发病时平均年龄为50岁。其中10例患者受累节段为C4-C5、C5-C6、C6-C7，6例患者受累节段为C3-C4、C4-C5及C5-C6。14例患者存在颈臂痛，2例为脊髓病。术前视觉模拟评分（Visual Analog Scale）平均为8/10，术后6个月的平均评分为3/10。术后6个月时，未发现影像学复发证据。1例患者出现非致命性并发症。结论：采用颈前路入路、3节段聚醚醚酮（PEEK）椎间融合器融合且不使用前路钢板固定的方式治疗颈椎椎间盘病，安全性与有效性均较为理想，在疼痛缓解与脊髓病症状改善方面可获得更优的长期疗效。该临床疗效可与其他同类研究队列相媲美，且最为重要的是，避免了与前路固定钢板相关的并发症。