Polyetheretherketone cages alone with allograft for three-level anterior cervical fusion

Hong Liu, Avraam Ploumis, Chunde Li, Xiaodong Yi, Hong Li, Hong Liu, Avraam Ploumis, Chunde Li, Xiaodong Yi, Hong Li

Abstract

A total of 25 consecutive patients suffering from degenerative cervical disc disease who underwent three-level anterior cervical discectomy and fusion (ACDF) including polyetheretherketone (PEEK) cages packed with allograft were followed up for at least two years. The fusion rate reached 72% (18/25), and asymptomatic pseudarthrosis was seen in 6 patients but without mobility on flexion-extension radiographs, and revision surgery was not needed. Cage subsidence occurred at one level (C67), but it was not progressive, and reoperation was not necessary. A significant increase (P < 0.001) in fused segment angle (FSA) and fused segment height (FSH) was observed postoperatively. Similarly, a significant clinical improvement (P < 0.001) was demonstrated postoperatively in terms of Japanese Orthopedic Association (JOA) score and visual analog scales (VASs) score. PEEK cages alone with allograft proved to be a safe and effective surgical option in the treatment of three-level degenerative cervical disc disease. Although the fusion rate was not high, this technique may offer improvement of symptomatology and maintenance of cervical spine's sagittal profile.

Figures

Figure 1
Figure 1
(a) Preoperative radiograph showing C3–C6 segment degeneration. (b) Preoperative sagittal T2W1 MR image revealed C34, C45, and C56 spinal cord compression. (c) Postoperative plain radiographs demonstrating adequate cervical lordosis and no cage subsidence 3 months (1) and one year (2) after ACDF. (d) Sagittal T2W1 MR image showing no spinal cord compression one year after ACDF. (e) Postoperative sagittal reconstruction CT image demonstrating C3–C6 fusion and no lucency between cages and endplates at one year postoperatively.

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