A pragmatic single centre retrospective comparative review of complication profile between PEEK cages and Zero-P cage screw constructs

Review of anterior cervical diskectomy/fusion (ACDF) using different polyetheretherketone (PEEK) cages

“…[1] Results 1]. [2,6] In 2016, Gerszten et al (2016) placed 3 to 4-level (i.e. total 110 levels) ZP PEEK ACDF with screws in 33 patients vs. SA PEEK ACDF cages in 35 patients without screws or plates; they found comparable VAS outcomes for both groups, but showed that ZP PEEK cages reduced dysphagia rates.…”

“…at 111 levels) performed over a 2-24 month follow-up period, they found no significant differences between the two regarding; adverse events/complications, sagittal balance, fusion rates, or incidence of subsidence [Table 1]. [2] Lower Fusion Rates for Titanium- 1]. [2,[9][10][11]13,14] Park et al, (2016) studied subsidence rates following 77 1-level stand-alone PEEK ACDF cage procedures (2005-2012); subsidence occurred in 26 of 77 (33.8%) patients, 25 of whom solidly fused, while another 47 of 51 patients without subsidence fused.…”

“…When Balakumar et al (2021) compared SA PEEK ACDF (83 patients) vs. ZP PEEK ACDF cage procedures (79 patients), there were just 2 instances of subsidence in the SA PEEK ACDF group, but none in those receiving ZP devices. [2] Double Lucency X-ray Sign of Titanium-Coated PEEK ACDF (Plus Autograft) Fusion 1]. [8] is sign, defined as consisting of a "complete radiolucent ring around Titanium markers" was seen in 91% of patients, and added confirmation of fusion.…”

“…Seventeen studies focused on the safety/efficacy between different ACDF PEEK cage constructs with occasional comparisons to "routine" ACDF controls [Table 1]. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] 1]. [4] PEEK ACDF cages resulted in comparable fusion rates, the same increases in foraminal area, and similar outcomes vs. ACDF/IA.…”

“…eir various designs include; Stand Alone (SA) or Zero Profile (ZP) cages with/without screws, cages filled with demineralized bone matrix (DBM) and/or autograft, and PEEK cages coated with hydroxyapatite or titanium [Table 1]. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Here, we reviewed 17 papers comparing the relative safety/efficacy of different single to 3 and 4-level PEEK cage ACDF constructs, with select comparisons to "routine" ACDF controls (i.e. typically using iliac autograft or allograft, and plates).…”