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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Circumferential arthrodesis using PEEK cages in degenerative lumbar pathology

Meeting Abstract

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  • M. A. Rousseau - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI, France
  • corresponding author J.-Y. Lazennec - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI, France
  • G. Saillant - Department of Orthopaedic Surgery, La Pitié - Salpétrière Hospital, University of Paris VI, France

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-02.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0008.shtml

Published: May 4, 2005

© 2005 Rousseau et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Polyetheretherketone (PEEK) has a low elasticity modulus, that reduces stress shielding, when used as interbody cage. It has been shown to favorize fusion and reduce subsidence rate in the short-term. The goal of this paper was to analyze the results of ALIF procedure using PEEK cages (Stryker) and cancellous bone autograft in addition to two-level pedicle screw posterior instrumentation (Domino, Stryker) in the longer term.

Methods

57 patients aged 54.6 (29 – 75) were reviewed. Six patients were overweighted. The level of arthrodesis was L2L3 in 6 cases, L3L4 in 9 cases, L4L5 in 31 cases, L5S1 in 11 cases. Cage height was 9 to 16 mm. Posterior instrmentation was rigid in 24 cases, and semi-rigid in 33 cases. Intersomatic bone graft represented 59.6% (20 – 95) of the vertebral plateau. While 47 patients had no change in lordosis after surgery, lordosis decreased of 8.2° (5 – 12) in ten cases. Lordosis decrease at follow-up was tested against age, obesity, level, bone graft amount, posterior instrumentation rigidity, post-op lordosis increase, and cage height.

Results

Average follow-up was 5.72 years (4 – 8). Clinical outcomes were excellent in 24 cases, good in 25 cases, fair in 6 cases and poor in 2 cases. Fusion was definite in 56 cases, and probable in one case. Lordosis decreased in 13 cases, of 5.6° (4 – 8). Multivariate analysis was significant (p<0.001; R2=0.590). Lost of correction was signifcantly related with post-op lordosis increase (p=0.01), rigid posterior instrumentation (p=0.026), age (p=0.047), level (p=0.013), and cage size (p<0.001).

Conclusions

Lumbar circumferential arthrodesis using PEEK cages provided good clinical results and fusion rate. However lordosis correction was not maintained in the long-term, specially at lower level, using big cages, in older patients, and when associated with rigid primary posterior instrumentation.