Outcome Analysis of Single Level Anterior Cervical Fusion using Interbody PEEK Cage with Autologous Iliac Bone Graft

Sang-Hun Lee; Kyung-Soo Suk; Ki-Tack Kim; Jung-Hee Lee; Eun-Min Seo; Yang-Sun Im

doi:10.4055/jkoa.2009.44.1.93

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Lee, Suk, Kim, Lee, Seo, and Im: Outcome Analysis of Single Level Anterior Cervical Fusion using Interbody PEEK Cage with Autologous Iliac Bone Graft

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(1): 93-101.

Published online: 23 February 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.1.93

Outcome Analysis of Single Level Anterior Cervical Fusion using Interbody PEEK Cage with Autologous Iliac Bone Graft

Sang-Hun Lee, M.D., Kyung-Soo Suk, M.D., Ki-Tack Kim, M.D., Jung-Hee Lee, M.D., Eun-Min Seo, M.D., Yang-Sun Im, M.D.

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to Kyung-Soo Suk, M.D. Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82.2-958-8345, Fax: +82.2-958-3865, skd111@khmc.or.kr

Abstract

Purpose

Anterior cervical fusion with a tricortical iliac bone graft is a well established procedure for treating degenerative cervical spine disease. An interbody cage has been used to prevent donor site morbidity but there are few reports on the clinical and radiological outcome.

Materials and Methods

Thirty eight patients, who underwent single level ACDF with PEEK interbody Solis®cage (Stryker spine, South Allendale, NJ, USA), were enrolled in this study. This study evaluated Odom's criteria and visual analogue scale (VAS) for the neck, arm and donor site pain, and the radiological findings, including the disk height, cage subsidence, and sagittal alignment of cervical spine.

Results

The mean disk height loss was 1.1 mm during the follow up period. Case subsidence >2 mm developed in 17 cases (44.7%). The mean subsidence of this group was 3.09 mm. The bone union rate was 95% at 12 weeks. There was no significant change in the sagittal alignment of the cervical spine. The VAS for neck, arm, and donor site pain improved all cases. Only 9 patients complained of mild discomfort at the donor site

Conclusion

Single-level ACDF using PEEK interbody cage has a lack of donor site morbidity, excellent clinical outcomes and bone union. However, more study of the factors related to postoperative cage subsidence will be needed.

Keywords: PEEK interbody cage, ACDF

Figures and Tables

Fig. 1

Photographs showing havesting technique of autologous bone with minimal incision at anterior iliac crest and PEEK cage (Solis®, Stryker spine) filled with cancellous bone.

Fig. 2

Lateral radiograph of cervical spine showing disc height measuring method. Disc height=A+M+P 3.

Fig. 3

Lateral radiograph of cervical spine showing cage subsidence measurement.

Fig. 4

Lateral radiograph of cervical spine showing segmental height measuring method.

Fig. 5

Serial radiographs of 64-year-old female patient underwent C5/6 anterior cervical fusion using stand alone PEEK cage. Preoperative (A) and immediate postoperative radiograph (B) show increased disc height in C5/6. Follow radiographs showing solid union without subsidence at 3 months (C) and 36 months after operation.

Fig. 6

Graph showing the clinical outcome analysis with VAS for neck, arm and donor site pain.

Fig. 7

Graph showing the change of mean disk height.

Fig. 8

Graph showing the change of mean segmental height.

Fig. 9

Graph showing the change of sagittal alignment of cervical spine.

Table 1

Odom's Criteria

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