Objective:

To compare the effectiveness between three-dimensional (3D) printed porous titanium alloy cage (3D Cage) and poly-ether-ether-ketone cage (PEEK Cage) in the posterior lumbar interbody fusion (PLIF).

Methods:

A total of 66 patients who were scheduled to undergo PLIF between January 2018 and June 2019 were selected as the research subjects, and were divided into the trial group (implantation of 3D Cage, n=33) and the control group (implantation of PEEK Cage, n=33) according to the random number table method. Among them, 1 case in the trial group did not complete the follow-up exclusion study, and finally 32 cases in the trial group and 33 cases in the control group were included in the statistical analysis. There was no significant difference in gender, age, etiology, disease duration, surgical segment, and preoperative Japanese Orthopaedic Association (JOA) score between the two groups (P>0.05). The operation time, intraoperative blood loss, complications, JOA score, intervertebral height loss, and interbody fusion were recorded and compared between the two groups.

Results:

The operations of two groups were completed successfully. There was 1 case of dural rupture complicated with cerebrospinal fluid leakage during operation in the trial group, and no complication occurred in the other patients of the two groups. All incisions healed by first intention. There was no significant difference in operation time and intraoperative blood loss between groups (P>0.05). All patients were followed up 12-24 months (mean, 16.7 months). The JOA scores at 1 year after operation in both groups significantly improved when compared with those before operation (P<0.05); there was no significant difference between groups (P>0.05) in the difference between pre- and post-operation and the improvement rate of JOA score at 1 year after operation. X-ray film reexamination showed that there was no screw loosening, screw rod fracture, Cage collapse, or immune rejection in the two groups during follow-up. At 3 months and 1 year after operation, the rate of intervertebral height loss was significantly lower in the trial group than in the control group (P<0.05). At 3 and 6 months after operation, the interbody fusion rating of trial group was significantly better in the trial group than in the control group (P<0.05); and at 1 year after operation, there was no significant difference between groups (P>0.05).

Conclusion:

There is no significant difference between 3D Cage and PEEK Cage in PLIF, in terms of operation time, intraoperative blood loss, complications, postoperative neurological recovery, and final intervertebral fusion. But the former can effectively reduce vertebral body subsidence and accelerate intervertebral fusion.

目的:

比较后路腰椎椎间融合术（posterior lumbar interbody fusion，PLIF）中，采用3D打印多孔钛合金椎间融合器（3D Cage）与聚醚醚酮（poly-ether-ether-ketone，PEEK）Cage的疗效差异。.

方法:

以2018年1月—2019年6月拟行PLIF的66例患者作为研究对象，按照随机数字表法分为试验组（植入3D Cage，n=33）与对照组（植入PEEK Cage，n=33）。其中试验组1例未完成随访排除研究，最终试验组32例、对照组33例纳入统计分析。两组患者性别、年龄、病因、病程、手术节段及术前日本骨科协会（JOA）评分等一般资料比较，差异均无统计学意义（P>0.05），具有可比性。比较两组手术时间、术中出血量及并发症发生情况，以及腰椎JOA评分、椎间隙高度丢失及椎间融合情况。.

结果:

两组手术均顺利完成。试验组术中出现硬膜破裂并发脑脊液渗漏1例，两组其他患者无并发症发生；术后切口均Ⅰ期愈合。试验组手术时间与术中出血量与对照组比较，差异均无统计学意义（P>0.05）。两组患者均获随访，随访时间12～24个月，平均16.7个月。两组术后1年JOA评分均较术前提高（P<0.05）；两组间手术前后差值及术后1年JOA 评分改善率比较，差异均无统计学意义（P>0.05）。X线片复查示随访期间两组均无螺钉松动、钉棒断裂、Cage塌陷和免疫排斥反应等发生。术后3个月及1年，试验组椎间隙高度丢失率均小于对照组（P<0.05）；术后3、6个月试验组椎间融合分级均优于对照组（P<0.05），术后1年两组差异无统计学意义（P>0.05）。.

结论:

PLIF术中选择3D Cage或PEEK Cage，在手术时间、术中出血量、并发症、术后神经功能恢复以及最终椎间融合方面均无明显差异，但前者能有效降低椎体沉降、加速椎间融合。.