Background

Conditions requiring cervical decompression and stabilization are commonly treated using anterior cervical discectomy and fusion using an anterior cage-plate construct. Anterior zero profile integrated cages are an alternative to a cage-plate construct, but literature suggests they may result in less motion reduction. Interfacet cages may improve integrated cage stability. This study evaluated the motion reduction of integrated cages with and without supplemental interfacet fixation. Motion reduction of integrated cages were also compared to published cage-plate results.

Methods

Seven cadaveric (C2-T1) spines were tested in flexion-extension, lateral bending, and rotation. Specimens were tested: 1) intact, 2) C6-C7 integrated cage, 3) C6-C7 integrated cage + interfacet cages, 4) additional integrated cages at C3-C4 and C4-C5, 5) C3-C4, C4-C5 and C6-C7 integrated cages + interfacet cages. Motion, lordosis, disc and neuroforaminal height were assessed.

Findings

Integrated cage at C6-C7 decreased flexion-extension by 37% (P = .06) and C3-C5 by 54% (P < .01). Integrated + interfacet cages decreased motion by 89% and 86% compared to intact (P < .05). Integrated cages increased lordosis at C4-C5 and C6-C7 (P < .01). Integrated + interfacet cages returned C3-C5 lordosis to intact values, while C6-C7 remained more lordotic (P = .02). Compared to intact, neuroforaminal height increased after integrated cages at C3-C5 (P ≤ .01) and at all levels after interfacet cages (P < .01).

Interpretation

Anterior integrated cages provides less stability than traditional cage-plate constructs while supplemental interfacet cages improve stabilization. Integrated cages provide more lordosis at caudal levels and increase neuroforaminal height more at cranial levels. After interfacet cages, posterior disc height and neuroforaminal height increased more at the caudal segments.

中文翻译：

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颈椎零轮廓综合笼的有效性，带或不带后路Interfacet稳定器。

背景

需要颈椎减压和稳定的疾病通常使用前颈椎间盘摘除术和前笼板结构融合治疗。前部零轮廓集成笼是笼板构造的替代方案，但文献表明它们可能导致运动减少。Interfacet笼可以提高集成笼的稳定性。这项研究评估了带或不带辅助界面固定的集成笼的运动减少。还比较了集成笼的运动减少与已发表的笼板结果。

方法

测试了七个尸体（C2-T1）棘的屈伸，横向弯曲和旋转。测试了以下样品：1）完整，2）C6-C7集成笼，3）C6-C7集成笼+界面笼，4）C3-C4和C4-C5处的其他集成笼，5）C3-C4，C4-C5和C6-C7集成笼+接口笼。评估运动，脊柱前凸，椎间盘和神经孔的高度。

发现

在C6-C7处的整合式保持架使屈伸度降低了37％（P = .06），而C3-C5则使弯曲度降低了54％（P <.01）。与完整的相比，集成+界面笼使运动减少了89％和86％（P <.05）。整合的笼子增加了C4-C5和C6-C7的脊柱前凸（P <0.01）。集成+界面笼使C3-C5脊柱前凸恢复到完整值，而C6-C7保持脊柱前凸（P = .02）。与完整相比，在C3-C5的整体笼中和在交界笼之后的所有水平上，神经孔的高度都增加了（P≤.01）。

解释

与传统的笼板结构相比，前部集成笼提供的稳定性较差，而补充性介面笼则提高了稳定性。一体式笼在尾水平提供更多的脊柱前凸，在颅水平进一步增加神经孔的高度。交界笼后，椎间盘的后椎高度和神经孔的高度在尾段增加更多。