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

Mastronardi, Luciano; Ducati, Alessandro; Ferrante, Luigi

doi:10.1007/s00701-005-0657-5

Cited by 93 publications

(90 citation statements)

References 33 publications

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“…The advantage would be that they could provide immediate stability and share the load on bone substitutes to prevent collapse. The results were comparable with those reported by some authors [1,6,16] who used other calcium phosphate ceramics. Additionally, the ample blood supply might be another reason for successful interbody fusion.…”

Section: Discussionsupporting

confidence: 90%

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Dai

Jiang

2008

Eur Spine J

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A variety of bone graft substitutes, interbody cages, and anterior plates have been used in cervical interbody fusion, but no controlled study was conducted on the clinical performance of b-tricalcium phosphate (b-TCP) and the effect of supplemented anterior plate fixation. The objective of this prospective, randomized clinical study was to evaluate the effectiveness of implanting interbody fusion cage containing b-TCP for the treatment of cervical radiculopathy and/or myelopathy, and the fusion rates and outcomes in patients with or without randomly assigned plate fixation. Sixty-two patients with cervical radiculopathy and/or myelopathy due to soft disc herniation or spondylosis were treated with one-or twolevel discectomy and fusion with interbody cages containing b-TCP. They were randomly assigned to receive supplemented anterior plate (n = 33) or not (n = 29). The patients were followed up for 2 years postoperatively. The radiological and clinical outcomes were assessed during a 2-year follow-up. The results showed that the fusion rate (75.0%) 3 months after surgery in patients treated without anterior cervical plating was significantly lower than that (97.9%) with plate fixation (P \ 0.05), but successful bone fusion was achieved in all patients of both groups at 6-month follow-up assessment. Patients treated without anterior plate fixation had 11 of 52 (19.2%) cage subsidence at last follow-up. No difference (P [ 0.05) was found regarding improvement in spinal curvature as well as neck and arm pain, and recovery rate of JOA score at all time intervals between the two groups. Based on the findings of this study, interbody fusion cage containing b-TCP following one-or two-level discectomy proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Supplemented anterior plate fixation can promote interbody fusion and prevent cage subsidence but do not improve the 2-year outcome when compared with those treated without anterior plate fixation.

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Section: Discussionsupporting

confidence: 90%

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Dai

Jiang

2008

Eur Spine J

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“…Unfortunately, the use of autogenous bone is associated with a significant degree of donor-site morbidity [1][2][3][4]. To avoid this adverse outcome, various bone graft substitutes, such as allograft [5,6], xenograft [4], DBM (demineralized bone matrix) [2], and cages [1,[6][7][8][9][10][11][12][13][14] have been used.…”

Section: Introductionmentioning

confidence: 99%

“…are currently used in ACDF. Polyetheretherketone (PEEK) cages have been widely utilized due to their biomechanical similarities to human bone, which prevent weakening of the vertebral bodies by decreasing the stress shield effect on the fusion site and accelerate bone fusion [6,8,10,12,13]. Currently, many surgeons perform these procedures without metal plate fixation [1,[6][7][8][9][10][11][12][13][14], which has an overall fusion rate, stability at the fusion site, and restoration of foraminal height comparable to the use of autogenous bone [1,6,8,10,13].…”

Section: Introductionmentioning

confidence: 99%

Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders

et al. 2010

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Anterior cervical discectomy and fusion (ACDF) with cage alone (ACDF-C) is associated with a significant incidence of subsidence, local kyphosis, and migration. The use of concurrent plate augmentation may decrease the incidence of these complications while improving the fusion rate. The purpose of the study is to present our results with ACDF with cage and plate augmentation (ACDF-CPA) and to compare these results to previous reports of outcomes following ACDF-C. We evaluated the radiologic and clinical parameters of 83 patients (266 fusion sites) who had an ACDF-CPA between March 2002 and May 2006. Radiologic parameters included fusion rate, fusion time, fusion type, site of pseudoarthrosis and rate and degree of subsidence. Clinical parameters included complications and overall outcomes assessed with Robinson's criteria; 79 of 83 patients showed bony fusion (95.1%) at last follow-up postoperatively, and there was no significant difference in fusion rate between the number of fusion levels. Type I (pseudoarthrosis) was noticed in 9 patients (12 fusion sites), type II in 14 (19 fusion sites), and type III in 60 (235 fusion sites). Five type I and all type II fusions converged into type III by the last follow-up; 76 of 83 patients (91.6%) experienced good clinical outcomes. Pseudoarthrosis occurred more commonly in more proximal locations, and the subsidence rate was significantly greater in two-level fusions when compared with single-level fusions (P = 0.046). There were four metal-related complications. Plate augmentation in one-or two-level anterior cervical fusions for degenerative cervical spine disorders may improve fusion rates and reduce subsidence and complication rates, resulting in improved clinical outcomes.

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“…ACDF can be performed using bone graft (8, 10), or a variety of titanium (11,29,31,52), carbon fiber (4,6,9,26,35,38,43,46,47) or pEEk cages (24,27,31). Recently, pEEk cages with pins and blades have been popular.…”

mentioning

confidence: 99%

Empty bladed peek cage for interbody fusion after acd

Gök

Onen²,

Yıldırım³

et al. 2014

Turkish Neurosurgery

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ABSTRACTassociated with uncontrolled fusion and cervical kyphosis, particularly in cases with 2 and 3 level CDH (30).On the other hand, the addition of a disc prosthesis after ACD has some theoretical advantages, including motion preservation, and reduced rate of adjacent segment disease. However, adjacent segment problem, heterotopic ossification and high cost related problems remain (45, 50).another technique, anterior cervical foraminotomy, is an effective technique, particularly for foraminal herniations. There is, however, a risk of injury to the vertebral artery and █ InTRODuCTIOnCervical disc herniation (CDH) is an important disorder affecting health care. Many surgical treatment modalities have been used to treat CDH, including anterior cervical discectomy (ACD) (30, 39,41), anterior cervical discectomy and fusion (ACDF) (1, 3, 6, 8-10, 16, 25-27, 29, 31, 35, 36, 38, 43, 46, 47), anterior foraminotomy (32, 42), keyhole foraminotomy (12, 18,40, 49), and arthroplasty (5, 19,36,41). Each approach has its advantages and disadvantages. ACD has been used for many years and has encouraging results in one level cases with a stable cervical spine. However, long term results of ACD are AIM: Cervical disc herniation (CDH) can be treated using different anterior and posterior methods. Anterior cervical discectomy and fusion (ACDF) is currently gold standard and provides bony fusion and good clinical outcome. Recently many studies reported good clinical and radiological outcomes in cases who underwent anterior cervical discectomy (ACD) and reconstruction with empty cage. This study aimed to review our results after cervical microdiscectomy reconstructed with empty polyether ether ketone (pEEk) cage. MATERIAl and METhODS:Twenty-five cases with single level CDH who underwent microdiscectomy were included to this study. Reconstruction was performed using empty bladed cervical PEEK cages. Clinical (Visual analogue scale (VAS) and Odom scores) and radiological results (intervertebral disc and foraminal heights, mean cervical spine lordosis angle, and fusion rate) were reviewed one day and one year after surgery.RESulTS: There were 18 males and 7 females, aged between 25 and 54 years (mean: 40.8). Mean neck and arm VAS scores reduced from 2.9 to 1.4, and from 7.2 to 1.8, respectively. Odom scores were found to be 1.6 and 1.4 at 1 st day and one year postoperatively, respectively. Subsidence was seen in three cases (12%). There was no significant change in heights of neural foramina and intervertebral discs, and no change in cervical spine lordosis, when compared postoperative 1 st day and one year radiographs. Fusion was detected in 92% of cases in one year.COnCluSIOn: Bladed cervical cages are safe with almost no risk of dislocation. Empty cages provide acceptable rates of fusion and subsidence.

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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

Abstract: 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.

Cited by 93 publications

References 33 publications

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Anterior cervical fusion with interbody cage containing β-tricalcium phosphate augmented with plate fixation: a prospective randomized study with 2-year follow-up

Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders

Empty bladed peek cage for interbody fusion after acd

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