3D打印钛合金椎间融合器置入治疗脊髓型颈椎病的临床疗效及颈椎矢状位参数变化

目的 探讨3D打印钛合金椎间融合器(3D Cage)置入治疗脊髓型颈椎病的临床疗效及颈椎矢状位参数变化.方法 回顾性研究我院2018年7月至2020年1月收治的接受单节段颈椎前路椎间盘切除植骨融合术(anterior cervical discectomy and fusion,ACDF)的脊髓型颈椎病病人39例,按照...

Clinical efficacy of 3D-printed titanium cage in the treatment of cervical spondylotic myelopathy and changes in cervical sagittal parameter

Objective To explore the clinical efficacy of 3D-printed titanium cage(3D Cage)in the treatment of cervical spondylotic myelopathy and changes in cervical sagittal parameter.Methods A retrospective study was performed on 39 patients with cervical spondylotic myelopathy in our hospital from July2018 to January 2020,who received 1-level anterior cervical discectomy and fusion,and were divided into the 3D group(18 cases)and the conventional group(21 cases)according to the implant.The length of hospital stay,operation time and intraoperative blood loss were compared between the two groups.Japanese Orthopaedic Association scores(JOA),visual analogue scale score(VAS)as well as neck disability index(NDI)were recorded before surgery,3 days after surgery and at the last follow-up.The sagittal parameters of the cervical standing radiographs were measured including intervertebral height,C2-7 Cobb angle,C2-7 sagittal axis distance(C2-7 SVA)and T1 slope,and the clinical efficacy was evaluated.Results There were no statistically significant differences in hospital stay,operation time,intraoperative blood loss,JOA,VAS and NDI scores at last follow up between the two groups.Three days after surgery,intervertebral height,C2-7 Cobb and T1 slope were significantly increased in both groups(P<0.05).The intervertebral height and C2-7 Cobb in the 3D group were 8.7±0.8 mm,18.6°±7.5°,significantly higher than those in the conventional group(9.3±0.9 mm,20.8°±7.3°).The T1 slope(24.2°±5.4°)at the last follow-up was significantly higher than that in the conventional group(P<0.05).At the last follow-up,the intervertebral height(7.2±0.9 mm)and T1 slope(20.7°±5.0°)were significantly reduced compared with 3 days after surgery in the conventional group(P<0.05).C2-7 SVA showed no statistical difference between groups or at any time period in the same group.Conclusion 3D-printed titanium cage implantation for the treatment of cervical spondylotic myelopathy has definite clinical efficacy and advantages in maintaining the intervertebral height,cervical curvature and T1 slope.