title: Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up.
abstract: OBJECTIVE
  Anterior cervical discectomy and fusion (ACDF) with titanium- or polyetheretherketone (PEEK)-cage reconstruction is widely used in the treatment of cervical spondylotic myelopathy (CSM). This study was to compare outcomes of titanium and PEEK cages in the treatment of multilevel CSM.
  
  
  METHODS
  Between November 2002 and December 2004, a total of 80 patients with 3-level CSM were randomized in a 1:1 ratio to titanium group and PEEK group. The overall follow-up period of the patients ranged from 86 to 116 months (average 99.7 months). Clinical and radiological results were compared between titanium group and PEEK group.
  
  
  RESULTS
  At the final follow-up, the clinical outcomes including JOA score, NDI score, and the excellent and good rates of clinical outcomes in the PEEK group were better than those in the titanium group. More loss of the Cobb angles and the intervertebral height was observed in the titanium group, resulting in the radiological parameters in the titanium group becoming inferior to the PEEK group at the final follow-up. Cage subsidence rates were 34.5 and 5.4% in the titanium and PEEK groups, respectively. Fusion was observed in all patients of two groups at the final follow-up. Two patients presented with cage dislocation without clinical symptoms in the titanium group.
  
  
  CONCLUSIONS
  In surgical treatment of multilevel CSM, PEEK cage is superior to titanium cage in maintenance of intervertebral height and cervical lordosis, resulting in better clinical outcomes in the long-term follow-up.
authors.affiliation: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, 200003 Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Xinwei
authors.initials: X
authors.lastname: Wang
authors.forename: Xuhua
authors.initials: X
authors.lastname: Lu
authors.forename: Lili
authors.initials: L
authors.lastname: Yang
authors.forename: Haisong
authors.initials: H
authors.lastname: Yang
authors.forename: Wen
authors.initials: W
authors.lastname: Yuan
authors.forename: Deyu
authors.initials: D
authors.lastname: Chen
mesh_terms: D001577:Benzophenones; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007659:Ketones; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011108:Polymers; D013123:Spinal Fusion / Q000295:instrumentation*; D055009:Spondylosis / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium