title: A Prospective Randomized Clinical Trial Comparing Bone Union Rate Following Anterior Cervical Discectomy and Fusion Using a Polyetheretherketone Cage: Hydroxyapatite/B-Tricalcium Phosphate Mixture versus Hydroxyapatite/Demineralized Bone Matrix Mixture.
abstract: METHODS
  Prospective randomized noninferiority trial.
  
  
  OBJECTIVE
  To evaluate whether the union rate of anterior cervical discectomy and fusion (ACDF) using a polyetheretherketone (PEEK) cage filled with a mixture of hydroxyapatite (HA) and demineralized bone matrix (DBM) is inferior to that of a mixture of β-tricalcium phosphate (β-TCP) and HA.
  
  
  BACKGROUND
  There have been no clinical trials investigating the outcomes of a mixture of HA and DBM in a PEEK cage in ACDF.
  
  
  METHODS
  Eighty-five eligible patients were randomly assigned to group B (n=43), in which a PEEK cage with a mixture of HA and DBM was used, or group C (n=42), in which a PEEK cage with a mixture of HA and β-TCP was used. The primary study endpoint was the fusion rate, which was assessed with dynamic radiographs and computed tomography (CT) scans. Secondary endpoints included pain intensity using a visual analogue scale, functional outcome using a neck disability index score, laboratory tests of inflammatory profiles, and the infection rate.
  
  
  RESULTS
  Seventy-seven patients (38 in group B and 39 in group C) were included in the final analysis. One year postoperatively, bone fusion was achieved in 87% of group B patients and 87% of group C patients on dynamic radiographs, and 87% of group B patients and 72% of group C patients on CT scans (p=1.00 and 0.16, respectively). There were also no between-groups differences with respect to the secondary endpoints.
  
  
  CONCLUSIONS
  A HA/DBM mixture inside a PEEK cage can provide noninferior outcomes compared to a HA/TCP mixture in ACDF.
authors.affiliation: Department of Orthopaedic Surgery, Kangwon National University College of Medicine, Chuncheon, Korea.
authors.forename: Jemin
authors.initials: J
authors.lastname: Yi
authors.affiliation: Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju, Korea.
authors.forename: Gun Woo
authors.initials: GW
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Kangwon National University College of Medicine, Chuncheon, Korea.
authors.forename: Woo Dong
authors.initials: WD
authors.lastname: Nam
authors.affiliation: Department of Orthopaedic Surgery, Kangwon National University College of Medicine, Chuncheon, Korea.
authors.forename: Kye Young
authors.initials: KY
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Sun General Hospital, Daejeon, Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Chamjoeun Hospital, Gwangju, Korea.
authors.forename: Jonghwa
authors.initials: J
authors.lastname: Won
authors.affiliation: Department of Orthopaedic Surgery, National Police Hospital, Seoul, Korea.
authors.forename: Seong Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Uijung-bu Chuk Hospital, Uijung-bu, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Noh
authors.affiliation: Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Sungnam, Korea.
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
keywords: Anterior cervical discectomy and fusion; Beta-tricalcium phosphate; Demineralized bone matrix; Hydroxyapatites; Polyetheretherketone cage