Anterior cervical fusion with polyetheretherketone (PEEK) cages in the treatment of degenerative disc disease. Preliminary observations in 36 consecutive cases with a minimum 12-month follow-up

Acta Neurochir (Wien). 2006 Mar;148(3):307-12; discussion 312. doi: 10.1007/s00701-005-0657-5. Epub 2005 Dec 12.

Abstract

Study design: Retrospective analysis of 36 cases of degenerative disc disease treated by interbody fusion with polyetheretherketone (PEEK) cages.

Objective: To determine the safety and efficiency of PEEK cages for anterior cervical fusion (ACF).

Summary of background data: ACF with autologous bone has been reported since over 50 years ago. The recent development of cages housing materials inducing osteogenesis simplifies the technique of interbody fusion. The main purposes of bone substitutes for ACF are immediate biomechanical support, osteo-integration of the graft, and elimination of local side effects at the donor site. This report shows our results using PEEK cages.

Materials and methods: During an 18-month period, 36 consecutive patients had cervical fusions at 43 levels between C3 and C7. All operations involved one or two disc spaces for degenerative disc disease. We implanted all disc spaces with PEEK cages (Stryker Corporation, Kalamazoo, MI) containing granulated coralline hydroxylapatite (Pro-Osteon 200, Interpore Cross International, Irvine, CA) or deantigenated pig bone in a gel solution (Gen-Os, Tecnoss, Torino, Italy).

Results: About 97% of patients had a good to excellent outcome; the result in one myelopathic patient was fair. The cervical fusion rate was 16.7% at 3 months, 61.1% at 6 months, and 100% at one year.

Conclusions: PEEK cages appear to be safe and efficient for ACF. In order to confirm our preliminary impressions studies on larger series with long term follow-up are warranted.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Benzophenones
  • Bone Regeneration / physiology
  • Bone Substitutes / adverse effects
  • Bone Substitutes / standards
  • Bone Substitutes / therapeutic use
  • Ceramics / adverse effects
  • Ceramics / standards
  • Ceramics / therapeutic use
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Coated Materials, Biocompatible / adverse effects
  • Coated Materials, Biocompatible / standards
  • Coated Materials, Biocompatible / therapeutic use*
  • Female
  • Humans
  • Hydroxyapatites / adverse effects
  • Hydroxyapatites / standards
  • Hydroxyapatites / therapeutic use
  • Internal Fixators / adverse effects
  • Internal Fixators / standards
  • Internal Fixators / trends*
  • Intervertebral Disc / pathology
  • Intervertebral Disc / surgery
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / physiopathology
  • Intervertebral Disc Displacement / surgery*
  • Ketones / adverse effects
  • Ketones / standards
  • Ketones / therapeutic use*
  • Length of Stay
  • Male
  • Middle Aged
  • Neck Pain / etiology
  • Neck Pain / surgery
  • Patient Satisfaction
  • Polyethylene Glycols / adverse effects
  • Polyethylene Glycols / standards
  • Polyethylene Glycols / therapeutic use*
  • Polymers
  • Postoperative Complications
  • Radiculopathy / etiology
  • Radiculopathy / surgery
  • Radiography
  • Retrospective Studies
  • Spinal Fusion / adverse effects
  • Spinal Fusion / instrumentation*
  • Spinal Fusion / methods*
  • Treatment Outcome

Substances

  • Benzophenones
  • Bone Substitutes
  • Coated Materials, Biocompatible
  • Hydroxyapatites
  • Ketones
  • Polymers
  • coralline hydroxyapatite
  • polyetheretherketone
  • Polyethylene Glycols