Cage containing a biphasic calcium phosphate ceramic (Triosite) for the treatment of cervical spondylosis.
BACKGROUND
We evaluated the fusion efficacy and clinical outcomes of a cage containing a biphasic calcium phosphate ceramic (Triosite) in treating cervical spondylosis.


METHODS
We randomly divided 100 patients with cervical spondylosis undergoing anterior discectomy with interbody polyetheretherketone (PEEK) fusion into 2 groups in the past 2 years: group A (n = 50), PEEK cage containing a biphasic calcium phosphate ceramic (Triosite), and group B (n = 50), PEEK cage containing an autogenous iliac bone graft. We compared the fusion rate, fusion time, spinal curvature, and neuroforamen size between the 2 groups. We also compared excess operation time, excess blood loss, hospital stay, complications, and neurological recovery status between the groups.


RESULTS
The fusion rates were 57%, 67%, 77%, 82%, 92%, and 100% in group A and 81%, 86%, 95%, 95% 100%, and 100% in group B in the first 6 postoperative months. The fusion rate in group A was significantly lower than that in group B in the first 5 months after the procedure (P < .05 and P < .01, respectively), but the fusion rate reached 100% in both groups by the sixth month. Within the first 6 months, as the fusion level increased, the fusion rates reduced and time to fusion was delayed in both groups. There were no donor site complications in group A. However, 3 patients (6%) from group B experienced complications (1, wound infection; 1, numbness of thigh; and 1, subcutaneous hematoma) (P < .001). The hospital stay was shorter in group A (4.43 +/- 2.36 days) than in group B (7.00 +/- 3.77 days) (P = .001). The mean excessive blood loss and excessive operative time for an iliac bone graft in group B were 15 +/- 5 mL and 10 +/- 6 minutes. There was no statistical significance in spinal curve correction, neuroforamen enlargement, and neurological recovery.


CONCLUSIONS
A cage containing a biphasic calcium phosphate ceramic resulted in complete fusion by the sixth postoperative month, although the fusion rate was lower than that in a cage containing an autograft during the first 5 months after the operation and the time to fusion was delayed. Using a cage containing a biphasic calcium phosphate ceramic leads to a shorter hospital stay, less blood loss, shorter operative time, and no donor site complications. It seemed to be a good substitute for cervical spondylotic fusion.
Cho
Der-Yang
DY
Department of Neurosurgery, China Medical University Hospital, Taichung, Taichung, Taiwan 404, Republic of China. d5057@www.cmuh.org.tw
Lee
Wuen-Yen
WY
Sheu
Pon-Chun
PC
Chen
Chun-Chung
CC
D020341:Absorbable Implants; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D002130:Calcium Phosphates / Q000627:therapeutic use*; D002574:Cervical Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017586:Diskectomy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D007085:Ilium / Q000637:transplantation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013128:Spinal Osteophytosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
D002130:Calcium Phosphates; D006882:Hydroxyapatites; C094280:hydroxyapatite-tricalciumphosphate composite