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Journal of Korean Neurosurgical Society > Volume 44(6); 2008 > Article
Journal of Korean Neurosurgical Society 2008;44(6): 370-374.
doi: https://doi.org/10.3340/jkns.2008.44.6.370
Radiologic Assessment of Subsidence in Stand-Alone Cervical Polyetheretherketone (PEEK) Cage.
Sung Kon Ha, Jung Yul Park, Se Hoon Kim, Dong Jun Lim, Sang Dae Kim, Sang Kook Lee
Department of Neurosurgery, Korea University Medical Center Ansan Hospital, Ansan, Korea. jypark@kumc.or.kr
ABSTRACT
OBJECTIVE:
Aim of study was to find a proper method for assessing subsidence using a radiologic measurement following anterior cervical discectomy and fusion (ACDF) with stand-alone polyetheretherketone (PEEK), Solis(TM) cage.
METHODS:
Forty-two patients who underwent ACDF with Solis(TM) cage were selected. With a minimum follow-up of 6 months, the retrospective investigation was conducted for 37 levels in 32 patients. Mean follow-up period was 18.9 months. Total intervertebral height (TIH) of two fused vertebral bodies was measured on digital radiographs with built-in software. Degree of subsidence (DeltaTIH) was reflected by the difference between the immediate postoperative and follow-up TIH. Change of postoperative disc space height (CT-MR DeltaTIH) was reflected by the difference between TIH of the preoperative mid-sagittal 2D CT and that of the preoperative mid-sagittal T1-weighted MRI.
RESULTS:
Compared to preoperative findings, postoperative disc height was increased in all cases and subsidence was observed only in 3 cases. For comparison of subsidence and non-subsidence group, TIH and CT-MRDeltaTIH of each group were analyzed. There was no statistically significant difference in TIH and CT-MR DeltaTIH between each group at 4 and 8 weeks, but a difference was observed at the last follow-up TIH (p=0.0497).
CONCLUSION:
ACDF with Solistrade mark cage was associated with relatively good radiologic long-term results. Fusion was achieved in 94.5% and subsidence occurred in 8.1% by the radiologic assessment. Statistical analysis reveals that the subsidence seen later than 8 weeks after surgery and the development of subsidence does not correlate statistically with the change of the postoperative disc space height.
Key Words: Cervical PEEK cage; Radiologic assessment; subsidence; Fusion rate; Anterior cervical discectomy and fusion
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