本研究旨在比较3D打印多孔钛和聚醚醚酮(PEEK)椎间融合器在颈椎前路椎间盘切除术和融合术(ACDF)中的差异。在PubMed中搜索了有关3D打印多孔钛和PEEK椎间融合笼在ACDF中的应用的文献,WebofScience,Embase,中国国家知识基础设施,万方和VIP数据库。共检索到1,181篇文章,最终纳入12篇。使用Cochrane偏倚风险评估标准和纽卡斯尔-渥太华量表进行质量评估,使用ReviewManager5.4进行数据分析。3DCage组在手术时间方面优于PEEKCage组[平均差异(MD):-7.68;95%置信区间(CI):-11.08,-4.29;P<0.00001],术中失血量(MD:-6.17;95CI:-10.56,-1.78;P=0.006),住院时间(MD:-0.57;95CI:-0.86,-0.28:P=0.0001),术后并发症[比值比(OR):0.35;95CI:0.15,0.80;P=0.01],C2-7Cobb角(MD:2.85;95CI:1.45,4.24;P<0.0001),椎间隙高度(MD:1.20;95CI:0.54,1.87;P=0.0004),日本骨科协会治疗评估(MD:0.69;95CI:0.24,1.15;P=0.003)和视觉模拟评分(MD:-0.43;95CI:-0.78,-0.07;P=0.02)。差异有统计学意义,两组间融合率差异无统计学意义(OR:1.74;95CI:0.71,4.27;P=0.23)。在ACDF中使用3D打印的多孔钛椎间融合笼具有操作时间短的优点,出血减少,住院时间短,术后并发症少。能更好地保持颈椎曲度和椎间高度,减轻疼痛,加速术后功能恢复。
The present study aimed to compare the differences between 3D-printed porous titanium and polyether ether ketone (PEEK) interbody fusion cages for anterior cervical discectomy and fusion (ACDF). Literature on the application of 3D-printed porous titanium and PEEK interbody fusion cages for ACDF was searched in the PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang and VIP databases. A total of 1,181 articles were retrieved and 12 were finally included. The Cochrane bias risk assessment criteria and Newcastle-Ottawa scale were used for quality evaluation and Review Manager 5.4 was used for data analysis. The 3D cage group was superior to the PEEK cage group in terms of operative time [mean difference (MD): -7.68; 95% confidence interval (CI): -11.08, -4.29; P<0.00001], intraoperative blood loss (MD: -6.17; 95%CI: -10.56, -1.78; P=0.006), hospitalization time (MD: -0.57; 95%CI: -0.86, -0.28: P=0.0001), postoperative complications [odds ratio (OR): 0.35; 95%CI: 0.15, 0.80; P=0.01], C2-7 Cobb angle (MD: 2.85; 95%CI: 1.45, 4.24; P<0.0001), intervertebral space height (MD: 1.20; 95%CI: 0.54, 1.87; P=0.0004), Japanese Orthopaedic Association Assessment of Treatment (MD: 0.69; 95%CI: 0.24, 1.15; P=0.003) and visual analogue scale score (MD: -0.43; 95%CI: -0.78, -0.07; P=0.02). The difference was statistically significant, while there was no significant difference between the two groups in terms of fusion rate (OR: 1.74; 95%CI: 0.71, 4.27; P=0.23). The use of 3D-printed porous titanium interbody fusion cage in ACDF has the advantages of short operation time, less bleeding loss, shorter hospitalization time and fewer postoperative complications. It can better maintain the cervical curvature and intervertebral height, relieve pain and accelerate postoperative functional recovery.