Objective: To compare the clinical effects of treating prolapse of the cervical intervertebral disc by the Solis cage fusion, the titanium cage fusion or the autogenous iliac crest graft combined with the titanium plate fixation.
Methods: Sixty-four patients with prolapse of the cervical intervertebral disc admitted to hospital from February 2002 to May 2005 were retrospectively analyzed. In Group A, 20 patients (15 males and 5 females, aged 38-76 years, 30 intervertebral spaces) were treated with the Solis cage fusion, and the preoperative JOA scores were 9-16, averaged 11.4; in Group B, 21 patients (15 males and 6 females, aged 37-78 years, 23 intervertebral spaces) were treated with the titanium cage fusion, and the preoperative JOA scores were 8-13, averaged 10.1; in Group C, 23 patients (18 males and 5 females, aged 32-76 years, 28 intervertebral spaces) were treated with the autogenous iliac crest graft combined with the titanium plate fixation, and the preoperative JOA scores were 9-14, averaged 10. 6. The comparative analysis was made among the 3 groups in the following aspects: X-ray exposure time, time working on the iliac bone, operation time, hemorrhage amount,complication incidence after operation, cervical vertebral fusion rate, symptom relief rate, and recovery rate of the JOA score.
Results: According to the follow-up for 2-15 months averaged 12 months, the time working on the iliac bone was longer in Group C than in Groups A and B (11.5 +/- 2.4 vs. 4.1+/- 1.7 min and 4.2 +/- 1.9 min, P < 0.05); the operation time was longer in Group C than in Groups A and B (98.3 +/- 14.7 min vs. 55. 5 +/- 10.3 min and 56.8 +/- 12.6 min, P < 0.05); and the X-ray exposure time was longer in Group C than in Groups A and B (7.8 +/- 1.8 min vs. 4.3 +/- 1.2 min and 4.2 +/- 1.3 min, P < 0.05). Also, the hemorrhage amount in Group C was much greater than in Groups A and B (145.8 +/- 19.3 ml vs. 65.8 +/- 10.2 ml and 67.2 +/- 12.3 ml, P < 0.05). The postoperative complication rate was lower in Groups A and B than in Group C (P < 0.05). There was a significant difference in the complication rate in the cervical region between Group A (5.0% +/- 1.8%) and Group B (14.3% +/- 2.6%, P < 0.05). The fusion rate in Groups A and B was 100% 3-4 months after operation, and there was no difference when compared with that in Group C. The recovery rates of the JOA scores in the three groups were 81.9% +/- 3.2%, 78.9% +/- 7.3%, and 76.3% +/- 9.4%, respectively, and there was no significant difference among the three groups.
Conclusion: The Solis cage fusion has a better therapeutic effect in treating prolapse of the cervical intervertebral disc than the titanium cage fusion and the autogenous iliac crest graft combined with the titanium plate fixation. The Solis cage fusion also makes the operation easier, with a more rapid recovery rate and fewer postoperative complications in the patient.