title: Vertebral body replacement with PEEK-cages after anterior corpectomy in multilevel cervical spinal stenosis: a clinical and radiological evaluation.
abstract: BACKGROUND
  A growing number of industrially manufactured implants have been developed in the last years for vertebral replacement in anterior cervical corpectomy and fusion (ACCF). Polyetheretherketone (PEEK)-cages are used in many centers, but outcome reports are scarce. This study assesses the clinical and radiological outcome after one- or two-level ACCF by the use of a PEEK-cage augmented by a plate-screw osteosynthesis.
  
  
  METHODS
  A total of 21 patients received one-level (18 patients) or two-level (3 patients) ACCF by a PEEK-cage and plate-screw osteosynthesis for multilevel degenerative stenosis. The Visual Analogue Scale, Nurick Score, Neck Disability Index and European Myelopathy Score were used for clinical assessment. Radiological outcome-osseous fusion and loss of height-was evaluated by CT.
  
  
  RESULTS
  The mean follow-up was 28 ± 12 months. In 19 patients, bony fusion was achieved after the primary operation. Graft failure that required surgical revision occurred in two patients. In these patients, osseous fusion was achieved after the second operation. Myelopathy improved significantly. The loss of height was 2.2 ± 2.3 and 5.3 ± 2.1 mm after one- and two-level ACCF, respectively.
  
  
  CONCLUSIONS
  Anterior corpectomy and fusion by a PEEK-cage and plate-screw osteosynthesis resulted in clinical improvement in all patients. Bony fusion was achieved in all patients in the long run. PEEK cages are allegedly less rigid than other xenografts. Similar to those, however, their use bears the risk of early cage-dislocation and subsidence. A comparison of industrial xenografts and autologous bone implants is required to challenge the different fusion techniques.
authors.affiliation: Department of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: Furat
authors.initials: F
authors.lastname: Raslan
authors.forename: Stefan
authors.initials: S
authors.lastname: Koehler
authors.forename: Frank
authors.initials: F
authors.lastname: Berg
authors.forename: Stefan
authors.initials: S
authors.lastname: Rueckriegel
authors.forename: Ralf-Ingo
authors.initials: RI
authors.lastname: Ernestus
authors.forename: Matthias
authors.initials: M
authors.lastname: Meinhardt
authors.forename: Thomas
authors.initials: T
authors.lastname: Westermaier
mesh_terms: D000328:Adult; D000368:Aged; D001577:Benzophenones; D001672:Biocompatible Materials; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation; D017586:Diskectomy / Q000379:methods; D005260:Female; D006801:Humans; D007659:Ketones; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011108:Polymers; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013130:Spinal Stenosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols