PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

Klingler, Jan-Helge; Krüger, Marie T.; Sircar, Ronen; Kogias, Evangelos; Scholz, Christoph; Volz, Florian; Scheiwe, Christian; Hubbe, Ulrich

doi:10.1155/2014/398396

Cited by 32 publications

(29 citation statements)

References 43 publications

(104 reference statements)

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“…They found fusion was achieved in 93.5% of patients after a median follow-up of 23 months. In the other 12 articles, the analysis was performed by a clinician, usually a neuro-or orthopaedic surgeon [12,29,35,61,67,69,87,92,96,[109][110][111]. They found fusion was achieved in 85.5% of patients after a median follow-up of 23 months.…”

Section: Methods Of Measuring Bony Fusionmentioning

confidence: 99%

“…Clinical outcome was assessed in relation to bony fusion in 18 studies ( Of these, 17 studies had a low risk of bias and 1 study had a high risk of bias. Out of these 18 studies, 3 found a statistically significant correlation between the occurrence of bony fusion and a good clinical outcome [109,120,122]. The other 15 studies did not find a correlation between bony fusion and clinical outcome.…”

Section: Correlation Between Bony Fusion and Clinical Outcomementioning

confidence: 97%

“…The study by Klingler et al [109] retrospectively compared patients treated with PEEK and PMMA implants. Clinical outcome was evaluated using the visual analogue scale (VAS), the neck disability index (NDI), the short-form 36 health survey (SF-36) and the patient satisfaction index (PSI).…”

Section: Correlation Between Bony Fusion and Clinical Outcomementioning

confidence: 99%

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Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

2018

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Purpose Anterior cervical discectomy and fusion (ACDF) has proven effective in treating radicular arm pain. Post-operatively, cervical spine stability is temporarily challenged, but data on bony fusion and speed of fusion are ambiguous; optimum evaluation method and criteria are debated. Aim To study bony fusion accomplishment and to obtain an overview of methods to evaluate fusion. Methods A literature search was performed in PubMed and Embase. Included studies had to report original data concerning 1-or 2-level ACDF with intervertebral device or bone graft, where bony fusion was assessed using CT scans or X-rays. Results A total of 146 articles comprising 10,208 patients were included. Bony fusion was generally defined as "the presence of trabecular bridging" and/or "the absence of motion". Fusion was accomplished in 90.1% of patients at the final follow-up. No gold standard for assessment could be derived from the results. Addition of plates and/or cages with screws resulted in slightly higher accomplishment of fusion, but differences were not clinically relevant. Eighteen studies correlated clinical outcome with bony fusion, and 3 found a significant correlation between accomplishment and better clinical outcome. Conclusions In approximately 90% of patients, bony fusion is accomplished one year after ACDF. As there is no generally accepted definition of bony fusion, different measuring techniques cannot be compared to a gold standard and it is impossible to determine the most accurate method. Variations in study design hamper conclusions on optimising the rate of bony fusion by choice of material and/or additives. Insufficient attention is paid to correlation between bony fusion and clinical outcome.Graphical abstract These slides can be retrieved from electronic supplementary material.

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Section: Methods Of Measuring Bony Fusionmentioning

confidence: 99%

Section: Correlation Between Bony Fusion and Clinical Outcomementioning

confidence: 97%

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Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

2018

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“…Because of the above-mentioned characteristics, in particular the good milling and grinding properties combined with high stability [6] similar to the stability of human bone [3], it is already used in various medical applications such as spine implant or bone substitute technology for large bone defects in traumatology [7,8].…”

Section: Introductionmentioning

confidence: 99%

Fracture load and failure types of different veneered polyetheretherketone fixed dental prostheses

et al. 2016

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OBJECTIVE The aim of this study is to investigate the fracture load of different veneered PEEK 3-unit fixed dental prosthesis (FDPs) after different aging regimens. METHODS Congruently anatomically shaped 3-unit FDPs were milled using a master stl-data set and randomly divided into four groups (N = 120, n = 30 per veneering group), which were veneered using different veneering methods: (i) digital veneering with breCAM.HIPC, (ii) conventional veneering with crea.lign, (iii) conventional with crea.lign paste, and (iv) using pre-manufactured veneers visio.lign. The FDPs were then adhesively cemented on a metal abutment and fracture loads were measured in a universal testing machine (1 mm/min) before and after aging (10,000 thermal cycles, 5/55°C). Two-and one-way ANOVA followed by post hoc Scheffé tests were used for data analysis (p < 0.05). RESULTS This investigation showed an influence of the veneering method on the fracture load results independent of the aging level. The highest fracture load was measured for the FDPs with digital veneering (1882 ± 152 N at baseline, 2021 ± 184 N after thermocycling). The remaining groups showed comparable results, and no impact of thermal aging was observed. Digital and conventional veneers showed cracks in the pontic region starting from the connector area as a main failure type after loading, while the pre-manufactured veneers showed predominantly adhesive failures. CONCLUSIONS The digital veneering method showed the highest fracture load resistance. Thermal aging showed no impact on the fracture load of all tested veneered PEEK 3-unit FDPs. CLINICAL RELEVANCE According to this study results, reliable veneering of PEEK FDPs can be achieved with digital veneering. Clinical relevance According to this study results, reliable veneering of PEEK FDPs can be achieved with digital veneering.

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“…Pseudo-arthrosis occurred in only two segments (3.3%). In comparison, Klingler et al, 17 reported ACDF in 51 levels using PEEK cages. Fusion occurred at (65%) after 20 months, while pseudo-arthrosis occurred in (35%).…”

Section: Discussionmentioning

confidence: 94%

Multi-level ACDF using standalone PEEK cages for the treatment of degenerative cervical myelopathy: Clinical and radiological assessment.

Allam

Al-Feki

2014

Egyptian Spine Journal

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Background Data: Degenerative cervical myelopathy is a complex neurologic disorder that usually develops insidiously, although abrupt deterioration in function can occur. The natural history of cervical myelopathy is highly variable, with some patients having progressive disability, whereas others have a mild course. The treatment of cervical myelopathy may be conservative or surgical, depending on the severity of symptoms at initial examination. Purpose: The aim of this work is to assess the clinical improvement as well as the bony fusion in patients with cervical myelopathy treated by multi-level ACDF using stand-alone PEEK cages. Study design: Clinical study Patients and Methods: The material of this study consisted of 20 patients with cervical myelopathy. The mean age was 52 years. 55% of the patients were males. The patients were assessed pre-operatively and post-operatively using the European Myelopathy Scoring (EMS). Fusion was assessed by X-ray at the end of follow up. Results: The mean operative time per level was 70 minutes. The mean blood loss was 150 ml. There were no intraoperative complications. The mean preoperative EMS was 8 points (6-11). At the end of follow up, the mean EMS improved to 14 points (11-18).The difference between the pre-operative and end follow up EMS was statistically significant (P < 0.001). 2 levels (3.3%) out of 60 showed x-ray evidence of pseudoarthrosis. Conclusions: Multi-level ACDF using stand-alone PEEK cages filled with local bone graft has many advantages in treating patients with degenerative cervical myelopathy. These include; minimal intraoperative and postoperative complications (including complications of anterior plating), avoidance of donor site morbidity, satisfactory clinical outcomes, and high fusion rate. (2014ESJ061)

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PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up

Cited by 32 publications

References 43 publications

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

Evaluation of bony fusion after anterior cervical discectomy: a systematic literature review

Fracture load and failure types of different veneered polyetheretherketone fixed dental prostheses

Multi-level ACDF using standalone PEEK cages for the treatment of degenerative cervical myelopathy: Clinical and radiological assessment.

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