Radiological and clinical outcomes in patients undergoing anterior cervical discectomy and fusion: Comparing titanium and PEEK (polyetheretherketone) cages.

Muhammad Junaid,Mamoon Ur Rashid,Syed Sarmad Bukhari,Mamoon Ahmed

doi:10.12669/pjms.346.15833

Abstract

Objectives:To study clinical and radiological outcomes in patients who had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages for cervical disc prolapse.Methods:This is a retrospective/non-randomized study which was conducted at the Combined Military Hospital Peshawar. Study interval was four years from 1st October, 2010 to 31st September, 2014. Total number of included patients were 149. All of the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages. All of the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse.Results:Most of the patients had stenosis at the C5 / C6 (PEEK cage group 63% and titanium cage group 47.6%) and C6 / C7 (PEEK cage group 15.38% and titanium cage group 19.04%) cervical level. Bi-level involvement was also seen. In the patients who complained of brachialgia, total resolution of symptoms was seen after the operation. Three (2.01%) of the patients in titanium cage group, who presented with axial neck pain, continued to complain of pain after the operation. Four (2.6%) of the patients in PEEK (polyetheretherketone) cage group and 2 (1.3%) in titanium cage group complained of pain at the donor site (iliac crest). Fusion rate was 100% with both titanium and PEEK (polyetheretherketone) cages at one year.Conclusion:Results with titanium and PEEK (polyetheretherketone) cages are excellent. There was no significant difference in clinical and radiological outcome between two groups of patients (p > 0.05). Fusion rate was 100% at one year with both cages.

Highlights

IntroductionDisc degeneration is one of the causes for intervertebral disc prolapse, for which both degenerative disc disease and aging are important.[1] Disc prolapse leads to compression of nerves and spinal cord due to which symptoms arise
Correspondence: June 7, 2018 June 9, 2018 October 4, 2018 October 6, 2018Disc degeneration is one of the causes for intervertebral disc prolapse, for which both degenerative disc disease and aging are important.[1]
The patients presented with following signs and symptoms: axial neckache, brachialgia, myelopathy, and poor hand grip/numbness

Summary

Introduction

Disc degeneration is one of the causes for intervertebral disc prolapse, for which both degenerative disc disease and aging are important.[1] Disc prolapse leads to compression of nerves and spinal cord due to which symptoms arise. There is evidence of chemical inflammation[2,3,4,5] in the causation of symptoms. Anterior cervical decompression and fusion is a procedure used for degenerative cervical diseases first reported in 1958. Pak J Med Sci November - December 2018 Vol 34 No 6 www.pjms.com.pk 1412 fusion. The gold standard is a cancellous bone graft taken from the iliac crest.[6] The auto graft taken from the iliac bone is associated with most of the complications like postoperative pain, hematoma formation, longer hospital stays, infection, longer operative time. The complication rate might range from 9.4 to 50% with this procedure.[7]

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