Titanium cage versus polyetheretherketone cage in posterior lumbar interbody fusion with pedicle screw fixation

doi:10.3969/j.issn.2095-4344.2015.43.012

Abstract

Abstract:

BACKGROUND: Due to the higher modulus of elasticity, titanium cages are prone to have the following shortcomings: adjacent vertebral sinking and delayed fusion resulting from stress shielding; therefore, in recent years, it has been gradually replaced by polyetheretherketone cages.
OBJECTIVE: To compare the clinical and radiographic outcomes of patients undergoing posterior lumbar interbody fusion with pedicle screw fixation in which either a polyetheretherketone cage or a titanium cage was implanted.
METHODS: The pre- and postoperative data of 104 patients who underwent single-level posterior lumbar interbody fusion were collected and analyzed, including 57 males and 47 females, aged (41.2±10.5) years. The 58 of 104 patients received the titanium cage and the remaining 52 patients received the polyetheretherketone cage. Visual analog scale scores and Japanese Orthopaedic Association Scores of the lumbar and lower limbs were recorded at 24 hours of postoperative follow-up; CT scan was used to detect bone fusion and cage subsidence.
RESULTS AND CONCLUSION: After 12 and 24 months of follow-up, the visual analog scale scores and
Japanese Orthopaedic Association Scores of the lumbar and lower limbs were all improved in the two groups compared with the previous (P < 0.05), but there was no difference between the two groups. At 12 and 24 months of follow-up, the fusion rates were 94% and 100% in the titanium cage group as well as 74% and 84% in the polyetheretherketone cage group, respectively, and a significant difference was found between the two groups (P=0.012 and P=0.016). At 24 months of follow-up, the subsidence rate was 36% in the titanium cage group and 30% in the polyetheretherketone cage group, and there was no difference between the two groups. These findings indicate that the superiority of polyetheretherketone cages over titanium cages has not been demonstrated.
中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Spinal Fusion, Decompression, Surgical, Lumbar Vertebrae, Tissue Engineering

Liu Rui-duan, Xiao Rong-chi, Tang Zhi-hong, Jin An-min. Titanium cage versus polyetheretherketone cage in posterior lumbar interbody fusion with pedicle screw fixation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(43): 6953-6957.

Figures/Tables 5

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