A Control Study On Self-locking Polyetheretherketone(PEEK) Cage And Autogenous Iliac Crest Graft Combined With Internal Plate Fixation Through Anterior Approach In The Treatment Of Cervical Spondylosis

Objectives:To assess the effects of the two cervical spinal fusion by comparing the operation time,the improvement rate of JOA scores,the correction of cervical physiological curvature and the restoring of intervertebral height in a control study on self-locking polyetheretherketone(PEEK)cage and autogenous iliac crest graft combined with internal plate fixation through anterior approach for the treatment of cervical spondylosis.Methods:A total of 102 patients underwent interbody fusion with PEEK cage or autogenous iliac crest graft combined with internal plate fixation from Jun 2005 to Jun 2008 were reviewed retrospectively.Patients in Group A(56 patients,106 segments) had anterior interbody fusion with PEEK cage,and patients in Group B(46 patients, 89 segments)had anterior interbody fusion with autogenous iliac crest graft combined with internal plate fixation.All patients in the two groups took the anteroposterior and lateral cervical X-ray examinations before operation,after operation and at the postoperative 3rd,6th and 12th month,and underwent two-dimensional sagittal CT reconstruction in 3～12 months after operation.Preoperative and postoperative JOA scores were evaluated based on clinical symptoms and signs,cervical physiological curvature was described based on the vertical distance between the midpoint of posterior margin of C4 and the straight line from the posterior margin of the dens to the posterior margin of C7 vertebral body and the intervertebral height was determined as the average value of anterior,middle and posterior intervertebral height of adjacent vertebra.Datas such as operation time,preoperative and postoperative JOA scores,cervical physiological curvature,and the intervertebral height were compared.Results:All patients were followed up for 10～30 months.The operation time in Group A was much less than that in Group B.At the 9th month of follow-up,patients in both Group A and Group B all had complete interbody fusion.Postoperative JOA scores in both Group A and Group B were more than the preoperative ones with significant differences,and the improvement rate of JOA scores had no statistical differences between group A and group B.Postoperative cervical physiological curvature and the intervertebral height in both Group A and Group B were better than the preoperative ones with statistical significances,and the degree of improvement had no statistical differences between Group A and Group B.Conclusions:Anterior polyetheretherketone(PEEK)cage can effectively restore the cervical physiological curvature and the intervertebral height,and it can achieve a satifactory fusion rate.It is a simple operation,and had minor soft tissue injury.At present,this is a good fusion operation in the treatment of cervical spondylosis.