title: Outcomes of interbody fusion cages used in 1 and 2-levels anterior cervical discectomy and fusion: titanium cages versus polyetheretherketone (PEEK) cages.
abstract: METHODS
  A prospective study was performed in case with cervical spondylosis who underwent anterior cervical discectomy and fusion (ACDF) with titanium or polyetheretherketone (PEEK) cages.
  
  
  OBJECTIVE
  To find out which fusion cage yielded better clinical and radiographic results.
  
  
  BACKGROUND
  Although use of autogenous iliac-bone grafts in ACDF for cervical disc diseases remain standard surgical procedure, donor site morbidity and graft collapse or breakage are concerns. Cage technology was developed to prevent these complications. However, there is no comparison regarding the efficacy between titanium and PEEK cage.
  
  
  METHODS
  January 2005 to January 2006, 53 patients who had 1 and 2-levels ACDF with titanium or PEEK cages were evaluated. We measured the rate and amount of interspace collapse, segmental sagittal angulations, and the radiographic fusion success rate. Odom criteria were used to assess the clinical results.
  
  
  RESULTS
  The fusion rate was higher in the PEEK group (100% vs. 86.5%, P=0.0335). There was no significant difference between both groups in loss of cervical lordosis (3.2 + or - 2.4 vs. 2.8 + or - 3.4, P=0.166). The mean anterior interspace collapse (1.6 + or - 1.0 mm) in the titanium group was significantly higher than the collapse of the PEEK group (0.5 + or - 0.6 mm) (P<0.0001). The mean posterior interspace collapse was also higher in the titanium group (1.6 + or - 0.9 mm vs. 0.5 + or - 0.5 mm, P<0.0001). An interspace collapse of 3 mm or greater was observed in 16.2% of the patients in the titanium group, compared with zero patients in the PEEK group (P<0.0001). The PEEK group achieved an 80% rate of successful clinical outcomes, compared with 75% in the titanium group (P=0.6642).
  
  
  CONCLUSIONS
  The PEEK cage is superior to the titanium cage in maintaining cervical interspace height and radiographic fusion after 1 and 2-levels anterior cervical decompression procedures.
authors.affiliation: Department of Orthopedics Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chi-Chien
authors.initials: CC
authors.lastname: Niu
authors.forename: Jen-Chung
authors.initials: JC
authors.lastname: Liao
authors.forename: Wen-Jer
authors.initials: WJ
authors.lastname: Chen
authors.forename: Lih-Huei
authors.initials: LH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001577:Benzophenones; D001672:Biocompatible Materials / Q000592:standards / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D017586:Diskectomy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000592:standards*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D007659:Ketones / Q000592:standards / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011092:Polyethylene Glycols / Q000592:standards / Q000627:therapeutic use*; D011108:Polymers; D011446:Prospective Studies; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000601:surgery; D014025:Titanium / Q000592:standards / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium