Multilevel Anterior Cervical Discectomy and Fusion with Polyetheretherketone (PEEK) Cages: Clinical Outcome and Fusion Assessment
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- Category: Vol. 80, March 2012
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Multilevel Anterior Cervical Discectomy and Fusion with Polyetheretherketone (PEEK) Cages: Clinical Outcome and Fusion Assessment,KHALED E. MOHAMED
Abstract
Background: Anterior cervical discectomy and fusion with polyetheretherketone (PEEK) cages showed good results for single level discectomy. For multiple levels sound fusion is required to decrease the incidence of pseudoarthrosis, and decrease the risk for re-surgery.
Objective: Is to assess the effectiveness of use of PEEK cages filled with autologous iliac crest bone graft in achieving good fusion, and in relieving the clinical manifestations of more than one level cervical disc disease.
Patients and Methods: The charts of thirty patients oper-ated for anterior cervical disc disease with more than one level were reviewed. Patients were operated and PEEK cages were used. Clinical assessment of pre-operative clinical data and post-operative status using Nurick scale for myelopathy, Odom’s criteria for functional outcome, and Visual Analogue Scale (VAS) for both neck and arm pain. Radiological fusion was assessed by X-ray, and Computerized Tomography CT scan. Operative complications were reported. Follow-up period at least 6 months.
Results: There were 18 patients operated for 2-level discectomy and fusion, and 12 patients operated for 3-level discectomy and fusion. Patients’ age ranged from 38 years to 63 years, a mean±SD 49±6.77. There were 18 (60%) males and 12 (40%) females. There was improvement of the post-operative Nurick scale record from 2.57±1.22 to 0.7±0.79; p-value was <0.001 (statistically significant). The VAS for radicular pain improved from 7.13±1.5 to be 0.47±0.97, p-value was 0.001 (statistically significant). The VAS for neck pain improved from 7.03±1.43 to 0.9±1.2, p-value was <0.001 (statistically significant). With Odom’s criteria, there were 15 patients (50%) with excellent outcome and 15 patients (50%) with good outcome. Fusion occurred in 24 patients (80%) of the study group, and non-fusion is reported in 6 patients (20%). There were 3 patients for each of the two and three-level. Out of 72 levels operated, there were 6 non-fused levels (8.3%).
Conclusion: Anterior cervical discectomy and fusion with PEEK cages filled with autologous bone graft for more than one level cervical disc disease achieved good clinical results and accepted fusion rates.