Michael J Kelly, Bradley Gelfand, Kris Radcliff, Fred F Mo, Brox A Felix, S Babak Kalantar
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Patient satisfaction was also evaluated.</p><p><strong>Results: </strong>A total of 789 ACDF patients (men: 51.5%/women: 48.5%; mean body mass index: 29.9 kg/m<sup>2</sup>) were included at the time of analysis, and 1565 segments have been operated. Successful fusion was confirmed in 91.3% of all operated levels after 6 months and 92.2% after 12 months. Mean NDI scores improved significantly (<i>P</i> < 0.01) preoperatively (46.3, <i>n</i> = 771) to postoperatively (12 months: 25.2, <i>n</i> = 281). Consistently, mean VAS neck (preoperative: 64.2, <i>n</i> = 770; 12 months: 28.6, <i>n</i> = 278), VAS right arm (preoperative: 42.6, <i>n</i> = 766; 12 months: 20.4, <i>n</i> = 277), and VAS left arm (preoperative: 41.1, <i>n</i> = 768; 12 months: 20.8, <i>n</i> = 277) decreased significantly (<i>P</i> < 0.01). Patients reported high satisfaction rates after surgery with no significant changes in postoperative patient satisfaction between 6 weeks and 12 months (95.1%, <i>n</i> = 273).</p><p><strong>Conclusions: </strong>ACDF with HA-infused PEEK cages demonstrates promising radiographic and clinical outcomes, supporting the potential benefits of incorporating HA into PEEK cages to enhance fusion rates and improve patient outcomes.</p><p><strong>Clinical relevance: </strong>This study demonstrates a >90% fusion rate by level with reliable improvements in patient reported outcomes, along with a high rate of patient satisfaction, in a large patient cohort undergoing ACDF with HA-infused PEEK cages.</p><p><strong>Level of evidence: </strong>2 .</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292562/pdf/","citationCount":"0","resultStr":"{\"title\":\"Interim 1-Year Radiographic and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion Using Hydroxyapatite-Infused Polyetheretherketone Interbody Cages.\",\"authors\":\"Michael J Kelly, Bradley Gelfand, Kris Radcliff, Fred F Mo, Brox A Felix, S Babak Kalantar\",\"doi\":\"10.14444/8585\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This is a multicenter observational registry analysis of 1-year radiographic and clinical outcomes following anterior cervical discectomy and fusion (ACDF) using hydroxyapatite (HA)-infused polyetheretherketone (PEEK) intervertebral cages.</p><p><strong>Methods: </strong>Radiographic and clinical outcome data were collected preoperatively and at 6 weeks, 3 months, 6 months, and 12 months postoperatively. To assess fusion, dynamic flexion-extension radiographs were independently evaluated with a validated method. Clinical outcomes were assessed using the following disease-specific measures: Neck Disability Index (NDI) and visual analog scale (VAS) for neck, left arm, and right arm pain. Patient satisfaction was also evaluated.</p><p><strong>Results: </strong>A total of 789 ACDF patients (men: 51.5%/women: 48.5%; mean body mass index: 29.9 kg/m<sup>2</sup>) were included at the time of analysis, and 1565 segments have been operated. Successful fusion was confirmed in 91.3% of all operated levels after 6 months and 92.2% after 12 months. Mean NDI scores improved significantly (<i>P</i> < 0.01) preoperatively (46.3, <i>n</i> = 771) to postoperatively (12 months: 25.2, <i>n</i> = 281). Consistently, mean VAS neck (preoperative: 64.2, <i>n</i> = 770; 12 months: 28.6, <i>n</i> = 278), VAS right arm (preoperative: 42.6, <i>n</i> = 766; 12 months: 20.4, <i>n</i> = 277), and VAS left arm (preoperative: 41.1, <i>n</i> = 768; 12 months: 20.8, <i>n</i> = 277) decreased significantly (<i>P</i> < 0.01). 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引用次数: 0
摘要
背景：这是对使用羟基磷灰石（HA）注入聚醚醚酮（PEEK）椎间笼进行颈椎前路椎间盘切除和融合术（ACDF）术后 1 年的影像学和临床疗效进行的一项多中心观察登记分析：方法： 收集术前、术后 6 周、3 个月、6 个月和 12 个月的影像学和临床结果数据。为评估融合情况，采用一种经过验证的方法对动态屈伸X光片进行独立评估。临床效果采用以下疾病特异性指标进行评估：颈部残疾指数（NDI）以及颈部、左臂和右臂疼痛的视觉模拟量表（VAS）。此外，还对患者的满意度进行了评估：分析时共纳入了 789 名 ACDF 患者（男性：51.5%/女性：48.5%；平均体重指数：29.9 kg/m2），共进行了 1565 个节段的手术。6个月和12个月后，分别有91.3%和92.2%的成功融合率。术前（46.3，n = 771）和术后（12 个月：25.2，n = 281）的平均 NDI 评分均有明显改善（P < 0.01）。颈部 VAS 平均值（术前：64.2，样本数：770；12 个月：28.6，样本数：278）、右臂 VAS 平均值（术前：42.6，样本数：766；12 个月：20.4，样本数：277）和左臂 VAS 平均值（术前：41.1，样本数：768；12 个月：20.8，样本数：277）均明显下降（P < 0.01）。患者术后满意度较高，术后6周至12个月患者满意度无明显变化（95.1%，n = 273）：结论：使用注入 HA 的 PEEK 骨架的 ACDF 具有良好的放射学和临床效果，支持将 HA 加入 PEEK 骨架以提高融合率和改善患者预后的潜在益处：这项研究表明，在使用注入 HA 的 PEEK 骨架进行 ACDF 的大型患者群中，融合率超过 90%，患者报告的结果也得到了可靠的改善，患者满意度很高。
Interim 1-Year Radiographic and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion Using Hydroxyapatite-Infused Polyetheretherketone Interbody Cages.
Background: This is a multicenter observational registry analysis of 1-year radiographic and clinical outcomes following anterior cervical discectomy and fusion (ACDF) using hydroxyapatite (HA)-infused polyetheretherketone (PEEK) intervertebral cages.
Methods: Radiographic and clinical outcome data were collected preoperatively and at 6 weeks, 3 months, 6 months, and 12 months postoperatively. To assess fusion, dynamic flexion-extension radiographs were independently evaluated with a validated method. Clinical outcomes were assessed using the following disease-specific measures: Neck Disability Index (NDI) and visual analog scale (VAS) for neck, left arm, and right arm pain. Patient satisfaction was also evaluated.
Results: A total of 789 ACDF patients (men: 51.5%/women: 48.5%; mean body mass index: 29.9 kg/m2) were included at the time of analysis, and 1565 segments have been operated. Successful fusion was confirmed in 91.3% of all operated levels after 6 months and 92.2% after 12 months. Mean NDI scores improved significantly (P < 0.01) preoperatively (46.3, n = 771) to postoperatively (12 months: 25.2, n = 281). Consistently, mean VAS neck (preoperative: 64.2, n = 770; 12 months: 28.6, n = 278), VAS right arm (preoperative: 42.6, n = 766; 12 months: 20.4, n = 277), and VAS left arm (preoperative: 41.1, n = 768; 12 months: 20.8, n = 277) decreased significantly (P < 0.01). Patients reported high satisfaction rates after surgery with no significant changes in postoperative patient satisfaction between 6 weeks and 12 months (95.1%, n = 273).
Conclusions: ACDF with HA-infused PEEK cages demonstrates promising radiographic and clinical outcomes, supporting the potential benefits of incorporating HA into PEEK cages to enhance fusion rates and improve patient outcomes.
Clinical relevance: This study demonstrates a >90% fusion rate by level with reliable improvements in patient reported outcomes, along with a high rate of patient satisfaction, in a large patient cohort undergoing ACDF with HA-infused PEEK cages.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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