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Implantation of an empty polyetheretherketone cage in anterior cervical discectomy and fusion: a prospective randomised controlled study with 2 years follow-up

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Abstract

Purpose

To compare the clinical outcomes, radiographic results and fusion rate of ACDF between empty PEEK cages and PEEK cages packed with β-tricalcium phosphate.

Methods

Forty-five patients were prospectively enrolled with cervical degenerative disc disease who requiring ACDF with a PEEK cage. 23 patients were randomised to the study group (empty cages) and 22 patients were in the control group (cages filled with β-tricalcium phosphate). Both patient groups were fixed with a cervical locking plate. A CT scan was performed 12 months postoperatively and 24 months if not confirmed fused at 12 months to evaluate the status of fusion. Clinical status was evaluated using the Japanese Orthopaedic Association (JOA) score, the Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS).

Results

46 levels (97.88%) in the study group and 44 levels (97.77%) in the control group were confirmed as fused at 24 months. There was no significant difference between the fusion rates observed in the study and control groups (p = 0.82). There was no significant difference in JOA, ODI, or VAS scores at 24 months follow-up. The results showed that the members of the non-fusion group tended to be older than the individuals in the fusion group at 12 months, but was not significant in statistics.

Conclusions

Similar fusion rates and clinical outcomes were achieved when using ACDF with PEEK cages and instrumentation, regardless of whether the cage was filled with bone substitute at 24 months follow-up. Fusion rates improved over time and are comparable between both groups.

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Acknowledgements

The study was supported by Division of Spine Surgery, Orthopaedic Department, Taipei Veterans General Hospital. We thank Hsin-Yi Huang from the Biostatistics Task Force, Taipei Veterans General Hospital, for the statistical assistance.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, No. 201, Section 2, Shi-pai Road, Taipei, 11217, Taiwan, ROC

    Shang-Wen Feng, Ming-Chau Chang, Po-Hsin Chou, Hsi-Hsien Lin, Shih-Tien Wang & Chien-Lin Liu

  2. School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC

    Shang-Wen Feng, Ming-Chau Chang, Po-Hsin Chou, Hsi-Hsien Lin, Shih-Tien Wang & Chien-Lin Liu

  3. Department of Orthopedics, National Yang-Ming University Hospital, Yilan, Taiwan, ROC

    Shang-Wen Feng

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  1. Shang-Wen Feng
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Feng, SW., Chang, MC., Chou, PH. et al. Implantation of an empty polyetheretherketone cage in anterior cervical discectomy and fusion: a prospective randomised controlled study with 2 years follow-up. Eur Spine J 27, 1358–1364 (2018). https://doi.org/10.1007/s00586-017-5450-7

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  • DOI: https://doi.org/10.1007/s00586-017-5450-7

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