Purpose

To evaluate whether a new PEEK vertebral body replacement can maintain the sagittal alignment as an anterior column reconstruction device in thoracic and lumbar spinal defects due to trauma or tumor.

Methods

Retrospective review of 48 patients who underwent a corpectomy between T5 and L5 due to trauma or tumor and were stabilized with the new PEEK vertebral body replacement, between 2013 and 2017. We excluded patients who underwent a corpectomy for infection or degenerative disease and patients without complete follow-up in our institution. The primary outcome was the bi-segmental kyphotic angle (BKA). Secondary outcomes were the assessment of pedicle screw loosening, cage height, and subsidence or tilting of the cage. The clinical outcomes were assessed through the COMI-Score, EuroQol-5D, and Karnofsky indexes. Bony fusion and complications were registered.

Results

After the surgery BKA decreased by 12.1° (p < 0.001). At the end of the follow-up, we observed a mean loss of reduction of 1.6° (p = 0.002). This was accompanied by an increase in subsidence of 2.1 mm (p < 0.001) and mean tilting of the cage of 1.4° (p = 0.003). The height of the cage and other parameters did not experience any changes.

Clinically, the COMI-Score (p = 0.02) and the EuroQol-5D Index (p = 0.012) showed significant improvement, same as Karnofsky-Index (p = 0.015) at final follow-up. The fusion rate according to Bridwell was 92.1%. The 2% late complications were related to implant malpositioning.

Conclusion

The new PEEK expandable vertebral body replacement is effective and safe in thoracic and lumbar anterior column reconstruction in tumor and trauma diseases.

中文翻译：

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新型模块化PEEK椎体置换装置重建胸腰椎前柱：对48例患者进行回顾性临床和影像学队列分析，随访1.7年。

目的

为了评估新的PEEK椎体置换术是否可以保持矢状面对齐，作为前柱重建装置治疗因创伤或肿瘤而导致的胸椎和腰椎脊柱缺损。

方法

在2013年至2017年之间对48例因创伤或肿瘤而在T5和L5之间进行了大体切除术并通过新的PEEK椎体置换术得以稳定的患者进行了回顾性回顾。我们排除了因感染或变性疾病而进行了大体切除术的患者和未完成的患者我们机构的后续行动。主要结局是双节后凸角（BKA）。次要结果是评估椎弓根螺钉松动，保持架高度以及保持架的下沉或倾斜度。通过COMI-Score，EuroQol-5D和Karnofsky指数评估临床结局。记录了骨融合和并发症。

结果

手术后，BKA下降了12.1°（p  <0.001）。在随访结束时，我们观察到平均减少损失为1.6°（p  = 0.002）。随之而来的是沉降量增加了2.1 mm（p  <0.001），笼子的平均倾斜角度为1.4°（p  = 0.003）。保持架的高度和其他参数没有任何变化。

临床上，COMI评分（p  = 0.02）和EuroQol-5D指数（p  = 0.012）表现出显着改善，与 最终随访时的Karnofsky指数（p = 0.015）相同。根据Bridwell的融合率是92.1％。2％的晚期并发症与植入物位置不当有关。

结论

新的PEEK可膨胀椎体置换术在肿瘤和创伤性疾病的胸椎和腰椎前柱重建中有效且安全。