Clinical Efficacy of Autogenous Vertebrae-Filled PEEK Cage in Anterior Cervical Discectomy and Fusion with Instrumentation

Abstract

This study aimed to investigate the clinical efficacy of the autologous vertebral-filled polyetheretherketone (PEEK) cage in anterior cervical discectomy and fusion with instrumentation (ACDFI). The clinical data of 368 patients who received ACDFI from September 2012 to September 2017 were retrospectively analyzed. Based on the material that filled PEEK cage during the surgery, the patients were divided into two groups, the autologous vertebrate group (n equal to 185) and the autologous iliac group (n equal to 183). The operative time, operative blood loss, postoperative complications in the two groups were recorded and analyzed. The bone graft fusion and postoperative functional outcomes, including scores of modified Japanese Orthopedic Association score (mJOA), Neck Disability Index (NDI), and Visual Analog Scale (VAS) were compared. Patients were followed-up for 14.04 ± 0.98 months. At 6-months follow-up, the rate of spinal fusion was 96.29% (178/185) in the vertebral group and 95.94% (176/183) in the iliac group, with no significant difference between the two groups (p > 0.05). The postoperative VAS, mJOA, and NDI scores were also not significantly different between two groups during the follow-up (p > 0.05). The operative time and blood loss in the vertebral group were significantly less than that of the iliac group (p < 0.01). All patients in the iliac group suffered pain at the iliac donor site, 65 patients suffered numbness, 12 patients had fat liquefaction at donor incision. Meanwhile, all the patients in the vertebral group had no postoperative complications. This study concluded that the autologous vertebrae-filled PEEK cage could achieve the same clinical outcome as the autologous iliac, but have the advantages of shorter operative time, less intraoperative blood loss, and postoperative complications.