title: PEEK cages as a potential alternative in the treatment of cervical spondylodiscitis: a preliminary report on a patient series.
abstract: The surgical management of cervical spondylodiscitis consists of the resection of the affected disc, the decompression of the cervical spinal cord, followed by the stabilization using an autologous bone graft or a titanium implant combined with a ventral plate fixation. Until now, there were no studies about the practicability and putative safety of PEEK cages in cervical spine infection. Now, we present the history of five patients suffering from neurological deficits and septicemia caused by mono- or bisegmental pyogenic cervical discitis and intraspinal abscess without severe bone destruction. Patients were treated surgically by discectomy, decompression, and ventral spondylodesis. The disc was replaced by a PEEK cage without additional fixation. Progressive bony fusion and complete regression of the inflammatory changes was demonstrated 7-8 months later by a computer assisted tomography and contrast enhanced magnetic resonance imaging, respectively. The vertebral alignment changed minimally; the cages developed only a slight average subsidence. The clinical symptoms improved in all patients significantly. Neck pain or instability was never observed. Nevertheless, prospective investigations of a larger patient series are mandatory. We suppose that the use of PEEK cages represents a potential and safe alternative in the treatment of cervical spondylodiscitis in selected patients.
authors.affiliation: Department of Neurosurgery, Medical Center of Friedrich-Schiller-University, Erlanger Allee 101, 07747, Jena, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Walter
authors.forename: Susanne Antje
authors.initials: SA
authors.lastname: Kuhn
authors.forename: Rupert
authors.initials: R
authors.lastname: Reichart
authors.forename: Rolf
authors.initials: R
authors.lastname: Kalff
authors.forename: Christian
authors.initials: C
authors.lastname: Ewald
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D013166:Spondylitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*