Early Outcomes of Anterior Cervical Discectomy and Fusion Using a Porous PEEK Interbody Fusion Device

Abstract

Background: Recently, porous surface polyether-etherketone (PEEK) implants have been developed to interact with adjacent endplates. Our goal was to evaluate the efficacy of novel high-strength, porous PEEK interbody fusion devices for anterior cervical discectomy and fusion (ACDF) in patients with symptomatic single-level and multilevel degenerative cervical disc disease at 1 year. Methods: Fifty consecutive patients (31 women, 19 men; average age, 60 years) with degenerative cervical disc disease underwent ACDF using a porous PEEK interbody implant and plate. There were 11 1-level; 23 2-level, and 16 3-level fusions between C3 and C7. Patients were assessed at 1.5, 3, 6, and 12 months. Standardized outcome measures were used to evaluate the patient’s condition before and after surgery. Plain radiographs were used to assess fusion, bony in-growth, subsidence, and implant migration. Sagittal plane angulation was measured on neutral lateral radiographs and determined by Cobb’s criteria. Intradiscal distraction and subsidence were measured by assessing the vertical distance between the midpoints of the adjacent vertebral endplates. Results: At 12 months after surgery, all patients showed improvement in Oswestry Neck Disability Index and neck and arm pain scores. Similarly, at 12 months, all patients showed radiographic fusion. No patient demonstrated motion across the interspace on flexion-extension lateral radiographs. Sagittal plane angulation improved to an average of -6° (range, -2° to -8°) with no measurable evidence of implant migration or subsidence. Average disc space height increased more than 4 mm. No patient had measurable radiographic evidence of a pseudarthrosis or halo formation around the implant. Conclusion: One-year results in this prospective nonrandomized study show that porous-surface PEEK is a clinically viable alternative for improving osseointegration and fusion rates of interbody implants to treat degenerative cervical disc disease.