Difference between 3D printed porous titanium alloy Cage and polyether ether ketone Cage in PLIF

doi:10.3760/cma.j.issn.1007-1245.2023.21.011

Abstract

Abstract:

Objective　To analyze the difference between 3D printed porous titanium alloy interbody fusion Cage (3D Cage) and polyether ether ketone interbody fusion cage (PEEK Cage) in posterior lumbar interbody fusion (PLIF). Methods　A total of 76 patients who planned to undergo PLIF in Henan Luoyang Orthopedic Hospital from February 2021 to February 2022 were selected as the study objects. According to different treatment plans, they were divided into an observation group (38 cases) and a control group (38 cases). In the observation group, there were 20 males and 18 females, aged 27-76 (45.67±9.69) years. In the control group, there were 19 males and 19 females, aged 26-74 (45.48±10.13) years. The observation group was implanted with 3D Cage under PLIF, and the control group was implanted with PEEK Cage under PLIF. The two groups were followed up for 1 year after surgery to compare the surgical indicators and complications. The height of intervertebral space and the degree of intervertebral fusion were compared between the two groups 3 months, 6 months, and 1 year after surgery. The Visual Analogue Scale (VAS) scores were compared between the two groups 12 h and 48 h after surgery. The Oswestry Disability Index (ODI) scores were compared between the two groups 3 months, 6 months, and 1 year after surgery. Independent sample t test, χ² test, and rank sum test were used. Results　The operation time, hospital stay, intraoperative blood loss, and postoperative drainage volume in the observation group were (123.26±23.62) min, (13.78±1.42) d, (316.64±26.79) ml, and (342.21±33.72) ml, respectively, those in the control group were (124.18±23.43) min, (14.16±1.37) d, (321.36±27.63) ml, and (346.38±34.17) ml, respectively, without statistically significant differences between the two groups (t=0.171, 1.187, 0.756, and 0.536; all P>0.05). The intervertebral space heights of the observation group 3 months, 6 months, and 1 year after surgery were (13.36±0.93) mm, (12.98±0.87) mm, and (12.21±0.62) mm, respectively, which were better than those of the control group [(12.78±1.21) mm, (12.33±0.94) mm, and (11.74±0.77) mm] (t=2.343, 3.128, and 2.931; all P<0.05). The intervertebral fusion degree of the observation group was better than that of the control group 3 months, 6 months, and 1 year after surgery (Z=2.734, 2.331, and 2.267; all P<0.05). The VAS scores in the observation group 12 h and 48 h after surgery were (5.18±1.24) and (4.23±1.12) points, respectively, which were lower than those in the control group [(5.87±1.36) and (5.06±1.21) points] (t=2.311 and 3.013, both P<0.05). The ODI scores of the observation group 3 months, 6 months, and 1 year after surgery were (24.62±6.34), (16.33±4.28), and (13.69±3.27) points, respectively, which were better than those of the control group [(28.86±7.21), (19.66±5.87), and (15.82±3.66) points] (t=2.722, 2.826, and 2.675; all P<0.05). Conclusion　There is no significant difference between the two kinds of Cage in the surgical indicators and postoperative complications of PLIF, but the 3D Cage can reduce the postoperative pain, better restore the height of the intervertebral space, and accelerate the intervertebral fusion, with good recovery of dysfunction.

Key words:

Posterior lumbar interbody fusion, 3D printing, Porous titanium alloy, Polyether ether ketone, Interbody fusion cage

摘要：

目的　分析3D打印多孔钛合金椎间融合器（3D Cage）与聚醚醚酮椎间融合器（PEEK Cage）在后路腰椎椎间融合术（PLIF）中的疗效差异。方法　选取2021年2月至2022年2月在河南省洛阳正骨医院76例行PLIF的患者作为研究对象，根据不同的治疗方案分为观察组（38例）和对照组（38例）。其中观察组男性20例，女性18例，年龄27～76（45.67±9.69）岁；对照组男性19例，女性19例，年龄26～74（45.48±10.13）岁。观察组在PLIF下植入3D Cage，对照组在PLIF下植入PEEK Cage。在手术后对两组患者进行1年随访，比较两组的手术指标与并发症发生情况；比较两组术后3个月、6个月以及1年的椎间隙高度与椎间融合度；比较两组术后12 h与48 h的视觉模拟评分法（VAS）评分；比较两组术后3个月、6个月以及1年的Oswestry功能障碍指数（ODI）评分。使用独立样本t检验、χ²检验、秩和检验。结果　观察组的手术时间、住院时间、术中出血量、术后引流量分别为（123.26±23.62）min、（13.78±1.42）d、（316.64±26.79）ml、（342.21±33.72）ml，对照组的手术时间、住院时间、术中出血量、术后引流量分别为（124.18±23.43）min、（14.16±1.37）d、（321.36±27.63）ml、（346.38±34.17）ml，两组比较差异均无统计学意义（t=0.171、1.187、0.756、0.536，均P>0.05）；观察组术后3个月、6个月以及1年的椎间隙高度分别为（13.36±0.93）mm、（12.98±0.87）mm、（12.21±0.62）mm，均优于对照组（12.78±1.21）mm、（12.33±0.94）mm、（11.74±0.77）mm（t=2.343、3.128、2.931，均P<0.05）；观察组术后3个月、6个月以及1年的椎间融合度均优于对照组（Z=2.734、2.331、2.267，均P<0.05）；观察组术后12 h与48 h的VAS评分分别为（5.18±1.24）分、（4.23±1.12）分，均低于对照组（5.87±1.36）分、（5.06±1.21）分（t=2.311、3.013，均P<0.05）；观察组术后3个月、6个月以及1年的ODI评分分别为（24.62±6.34）分、（16.33±4.28）分、（13.69±3.27）分，均优于对照组（28.86±7.21）分、（19.66±5.87）分、（15.82±3.66）分（t=2.722、2.826、2.675，均P<0.05）。结论　两种椎间融合器在PLIF中的手术指标和术后并发症发生情况方面均无明显差异，但3D Cage能够减轻术后疼痛，更好恢复椎间隙高度以及加速椎间融合，且功能障碍情况恢复良好。

关键词:

后路腰椎椎间融合术, D打印, 多孔钛合金, 聚醚醚酮, 椎间融合器

Zhou Xianwei, Yu Yang, Liu Yufeng, Zhang Xiaohui, Zhang Wenming, Song Jian, Yan Xiang.

Difference between 3D printed porous titanium alloy Cage and polyether ether ketone Cage in PLIF [J]. International Medicine and Health Guidance News, 2023, 29(21): 3035-3039.

周献伟于洋刘玉峰张晓辉张文明宋健闫翔.

3D打印多孔钛合金Cage与聚醚醚酮Cage在PLIF中的疗效差异 [J]. 国际医药卫生导报, 2023, 29(21): 3035-3039.

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