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Vertebral Endplate Cyst Formation in Relation to Properties of Interbody Cages

Neurospine 2021년 18권 1호 p.170 ~ 176
Sasaki Manabu, Umegaki Masao, Fukunaga Takanori, Hijikata Yasukazu, Banba Yohei, Matsumoto Katsumi, Miyao Yasuyoshi,
소속 상세정보
 ( Sasaki Manabu ) - Iseikai Hospital Department of Neurosurgery and Spine Surgery
 ( Umegaki Masao ) - Iseikai Hospital Department of Neurosurgery and Spine Surgery
 ( Fukunaga Takanori ) - Iseikai Hospital Department of Neurosurgery and Spine Surgery
 ( Hijikata Yasukazu ) - Kitasuma Hospital Department of Spine and Lumbago Center
 ( Banba Yohei ) - Iseikai Hospital Department of Neurosurgery and Spine Surgery
 ( Matsumoto Katsumi ) - Iseikai Hospital Department of Neurosurgery and Spine Surgery
 ( Miyao Yasuyoshi ) - Suita Municipal Hospital Department of Neurosurgery

Abstract


Objective: This retrospective study aimed to compare vertebral endplate cyst formation (VECF), an early predictor for pseudoarthrosis, in different types of interbody cages.

Methods: We reviewed 84 cases treated with single-level posterior/transforaminal lumbar interbody fusion. We utilized a polyetheretherketone cage in 20 cases (group P), a titanium cage in 16 cases (group Ti), a titanium-coating polyetheretherketone cage in 13 cases (group TiP) and a porous tantalum cage in 35 cases (group Tn). VECF was evaluated comparing the computed tomography scans taken at day 0 and 6-month postoperation. We defined VECF (+) as enlargement of a pre-existing cyst or de novo formation of a cyst with the diameter over 2 mm. We calculated the adjusted odds ratio (OR) and 95% confidence intervals (CIs) as an indicator of association between different types of cages and VECF using a logistic regression model.

Results: VECF was observed in 13 (65%), 7 (44%), 9 (69%), and 8 (23%) cases in groups P, Ti, TiP and Tn, respectively. VECF correlated with the type of cage (p = 0.04). In comparison with group P, the proportion of VECF (+) cases was lower in group Tn (OR, 0.16; 95% CI, 0.04?0.60) but not different in group Ti (OR, 0.47; 95% CI, 0.10?2.20) and group TiP (OR, 1.06; 95% CI, 0.21?5.28). No patient underwent additional surgery for the fused spinal level during the follow-up periods (average, 37.9 months; range, 6?76 months).

Conclusion: VECF was the least in the porous Tn cage, suggesting its potential superiority for initial stability.

키워드

Vertebral endplate cyst formation; Polyetheretherketone; Titanium; Tantalum; Posterior lumbar interbody fusion; Interbody cage

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