Abstract
BackgroundThis meta-analysis was performed to identify the benefits and disadvantages of the PEEK cage and titanium cage.MethodsWe used “cervical or cervicle”, “titanium”, and “polyetheretherketone or PEEK” as keywords. Medline, Embase, Cochrane Central Register of Controlled Trials and other databases were searched to identify eligible studies that were published before October 2015. In addition, the Google search engine was used to manually search for relevant journals or conference proceedings. Randomized controlled trials and non-randomized controlled trials that compared the PEEK cage and titanium cage for anterior cervical surgery were included. The meta-analysis was performed with RevMan 5.1 software.ResultsTwo randomized and two non-randomized clinical trials were retrieved with a total of 184 segments from 107 patients in the PEEK cage group and 211 segments from 128 patients in the titanium cage group. The quality assessment scores ranged from 16 to 18 with high heterogeneity. There were no differences in functional status according to the Odom criteria, fusion rate, final local segmental angle and loss of correction between the two groups. Although more subsidence occurred in the titanium cage group, the effects of loss of the local segmental angle or the whole cervical Cobb angle on cervical function in the long-term are still not clear.ConclusionThe present meta-analysis indicated no significant difference in functional and radiographic performance between the PEEK and titanium cages, although more subsidence occurred in the titanium cage group. More high-quality studies are needed to confirm these results to offer more information for the choice in clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1234-1) contains supplementary material, which is available to authorized users.
Highlights
This meta-analysis was performed to identify the benefits and disadvantages of the PEEK cage and titanium cage
Individual patient data were available from these articles without the data for those lost to follow-up
Most baseline parameters were comparable except that the patients of the PEEK cage group were older than the titanium cage group in the study by Cabraja et al [20]
Summary
This meta-analysis was performed to identify the benefits and disadvantages of the PEEK cage and titanium cage. To immobilize the unstable motion segment after discectomy, we have to ensure bony fusion and avoid donor site complications at the same time; some fusion devices have been developed for stand-alone use or use in combination with an anterior plate. Some veterinary surgeons and the distraction compression method and was the basic principle for stand-alone intervertebral cage fusion. The principle was invented to solve a cervical problem, the carbon fiber fusion cage [6] and titanium cage [7] were first used for lumbar inter-body fusions, and they were applied to treat cervical spinal degenerative lesions by Hacker [8] and Profeta [9] in 2000. The ideal cage has to have a high fusion rate and prevent complications, such as subsidence and loss of correction
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