title: Three- and four-level anterior cervical discectomy and fusion with a PEEK cage and plate construct.
abstract: BACKGROUND
  Three- or four-level anterior cervical discectomy and fusion with autograft and plate fixation have demonstrated relatively good fusion rates and outcomes, but donor site morbidity and the limitations of autograft harvest remain problematic. The purpose of this study is to assess the radiographic and clinical outcomes of three- or four-level anterior cervical discectomy and fusion with a PEEK cage and plate construct.
  
  
  METHODS
  This retrospective review included 43 consecutive patients who underwent three- or four-level anterior cervical discectomy and fusion with a PEEK cage and plate construct (three level: 39 cases, four level: 4 cases). The fusion rate, time to fusion, Cobb angle and disc height were assessed radiographically. Clinical outcomes were evaluated with the VAS, NDI, and SF36 scores. Complications were also recorded.
  
  
  RESULTS
  Solid fusion was achieved in all the patients, and mean time to fusion was 13.7 ± 5.1 weeks. The postoperative Cobb angle, lordotic angle, and disc height (5.6°, 10.5° and 3.15 mm, respectively) increased significantly compared to preoperative values (p = 0.038, p = 0.032, and p = 0.0004, respectively), and these improvements were maintained through final follow-up. The postoperative NDI (17.2), VAS (2.8), and SF36 (13.1) scores increased significantly compared to the preoperative scores (p = 0.026, p = 0.0007 and p = 0.041, respectively). Complications included three cases of respiratory difficulty, four cases of dysphagia and one case of hoarseness. There were no cases of donor site morbidity.
  
  
  CONCLUSIONS
  Three- or four-level anterior cervical discectomy and fusion with a PEEK cage, and plate construct provide good clinical and radiographic outcomes including high fusion rates, low complication rates, low donor site morbidity, and good maintenance of the lordotic angle and disc height in the treatment of multilevel cervical spondylosis.
authors: Department of Orthopedic Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Research Institute of Clinical Medicine, 634-18 Keuam-dong, Jeonju, Chonbuk, South Korea.
authors: Kyung-Jin
authors: KJ
authors: Song
authors: Sun-Jung
authors: SJ
authors: Yoon
authors: Kwang-Bok
authors: KB
authors: Lee
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000601:surgery*