Polyetheretherketone interbody cages versus autogenous iliac crest bone grafts with anterior fixation for cervical disc disease

J Spinal Disord Tech. 2013 Apr;26(2):61-7. doi: 10.1097/BSD.0b013e3182323274.

Abstract

Objective: The aim of this study was to compare the fusion rate, operation time, recovery of disc space height, clinical duration and improvement, return to activities of daily living, and complication rate associated with anterior cervical discectomy with interbody fusion by using polyetheretherketone cages or autogenous iliac crest bone grafts as disc replacement in a series of 60 patients.

Materials and methods: Between November 2006 and February 2010 a retrospective analytical observational cohort study was carried out in 60 consecutive patients surgically treated with anterior cervical discectomy with interbody fusion for degenerative disc desease at the Neurosurgical Department of the Hospital Italiano de Buenos Aires. The patients were divided into 2 groups for the assessment of clinical characteristics, demographics, fusion rates, duration of surgical procedure, neurological and functional outcomes, imaging results, and complications. Group A included patients treated with autogenous iliac crest bone grafts, and group B included patients treated with polyetheretherketone cages.

Results: The mean age of the patients was 50.8 years. Female patients comprised the majority in both groups (63.3%). Cervicobrachialgia was the most common presentation. Clinical improvement, fusion rates, and recovery of disc space height were similar in both groups. The operation time was significantly shorter in the polyetheretherketone group (P<0.001). Twenty percent (n=6) of the patients in group A suffered complications, >80% of which were associated with iliac crest bone graft harvesting. Patients in group B had no complications (P<0.05).

Conclusions: Although outcomes were very successful in both groups in terms of fixation stability, recovery of disc space, return to activities of daily living and work, and remission of symptoms, operation time was considerably shorter for patients in the polyetheretherketone group, who had none of the complications associated with iliac crest bone graft harvesting, both differences being statistically significant.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Benzophenones
  • Bone Transplantation / methods*
  • Bone Transplantation / standards
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Cohort Studies
  • Diskectomy / instrumentation
  • Diskectomy / methods
  • Diskectomy / standards
  • Female
  • Follow-Up Studies
  • Humans
  • Internal Fixators* / standards
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / surgery*
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / surgery*
  • Ketones / administration & dosage*
  • Ketones / standards
  • Male
  • Middle Aged
  • Polyethylene Glycols / administration & dosage*
  • Polyethylene Glycols / standards
  • Polymers
  • Radiography
  • Retrospective Studies
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods
  • Spinal Fusion / standards
  • Transplantation, Autologous

Substances

  • Benzophenones
  • Ketones
  • Polymers
  • polyetheretherketone
  • Polyethylene Glycols

Supplementary concepts

  • Intervertebral disc disease