Abstract
BackgroundFinite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases.MethodsFrom January 2015-December 2017, 28 patients who underwent lumbar posterior hybrid surgery with PEEK rods were included in the study. The patients were diagnosed with lumbar disc herniation, lumbar spinal stenosis, or degenerative grade I spondylolisthesis. Before the operation and at the last follow-up, the patients completed lumbar anteroposterior and lateral X-ray, dynamic X-ray, MRI examinations. In addition, at the last follow-up the patients also completed lumbar CT examinations. The radiographic parameters, clinical visual analog scale (VAS) score and Oswestry disability index (ODI) score were compared.ResultsThe average age of the patients was 44.8 ± 12.6 years, and the average follow-up duration was 26.4 ± 3.6 months. The VAS score improved from 6.3 ± 1.6 to 1.0 ± 0.9, and the ODI score decreased from 38.4 ± 10.8 to 6.8 ± 4.6. The fusion rate of the fused segment was 100%. There were no significant changes in the modified Pfirrmann classifications or disc height index for the nonfused segments and the upper adjacent segments from pre- to postoperatively. No cases of screw loosening, broken screws, broken rods or other mechanical complications were found.ConclusionHybrid surgery with PEEK rods for lumbar degenerative diseases can yield good clinical results and effectively reduce the incidence of complications such as adjacent segment diseases.
Highlights
Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration
The visual analog scale (VAS) score improved from 6.3 ± 1.6 to 1.0 ± 0.9 (p < 0.05), and the Oswestry disability index (ODI) score decreased from 38.4 ± 10.8 to 6.8 ± 4.6 (p < 0.05)
The results showed that compared with titanium rods, PEEK rods could reduce the stress on the facet joints and disc of the upper adjacent segment and increase the stress on the intervertebral cage and bone graft
Summary
Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases. With the development of suitable biomechanical materials, elastic fixation and semirigid fixation have emerged. Elastic fixation, such as the Dynesys system, retains the mobility of the corresponding segment but increases the. Payer et al [3] used the Dynesys system to treat patients with single-segment degenerative spondylolisthesis and spinal stenosis, and the results showed that it could not effectively prevent the occurrence of ASD. A 5-year follow-up study showed that the incidence of screw loosening was as high as 20% [4]
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