title: Multilevel cervical fusion without plates, screws or autogenous iliac crest bone graft.
abstract: OBJECTIVE
  This prospective study was performed to evaluate the safety and efficacy of polyetheretherketone (PEEK) cages packed with demineralized bone matrix (DBM) mixed with autologous blood and curettage microchip material for treatment of multilevel cervical disc disease and spondylosis without the use of plates, screws or autogenous iliac crest bone graft.
  
  
  METHODS
  Sixteen patients underwent multilevel anterior cervical discectomy and fusion (ACDF) for a total of 42 levels. Minimum follow-up was 18 months. Neurological outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scoring system; cervical lordosis and cervical fusion status was assessed on X-ray. Statistical analysis was performed to compare preoperative and postoperative scores using a dependent t-test (P<0.05).
  
  
  RESULTS
  Eight patients underwent two-level, six underwent three-level and two underwent four-level operations. The fusion rate was 90.5% and non-fusion rate was 9.5%, but reoperation was not required for these patients in the follow-up period. Cervical lordosis was preserved and neurological status was improved. No cage migration or cage failure occured.
  
  
  CONCLUSIONS
  ACDF using PEEK cages packed with DBM is a safe and efficient method for treatment of multilevel cervical disc disease and spondylosis. It preserves cervical lordosis and obviates the complications related to iliac crest graft harvest and screw-plate fixation.
authors.affiliation: GATA Haydarpasa Training Hospital, Department of Neurosurgery, Istanbul, Turkey. mehmetnusretdemircan@yahoo.com
authors.forename: Mehmet Nusret
authors.initials: MN
authors.lastname: Demircan
authors.forename: Ahmet Murat
authors.initials: AM
authors.lastname: Kutlay
authors.forename: Ahmet
authors.initials: A
authors.lastname: Colak
authors.forename: Serdar
authors.initials: S
authors.lastname: Kaya
authors.forename: Tamer
authors.initials: T
authors.lastname: Tekin
authors.forename: Kenan
authors.initials: K
authors.lastname: Kibici
authors.forename: Kaan
authors.initials: K
authors.lastname: Ungoren
mesh_terms: D000328:Adult; D001577:Benzophenones; D001860:Bone Plates / Q000600:supply & distribution; D001863:Bone Screws; D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D017586:Diskectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007659:Ketones / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011108:Polymers; D011446:Prospective Studies; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols