Efficacy of titanium-coated PEEK cages with two blades in anterior cervical decompression fixation: Bone fusion rates and surgical outcomes.

Abstract

Background: Cervical degenerative diseases are prevalent in aging populations. Anterior cervical discectomy and fusion is a common surgical intervention. This study aimed to compare the efficacy of titanium-coated polyether ether ketone cages with blades and artificial bone grafting with that of conventional polyether ether ketone cages with screws and autologous bone grafting in anterior cervical discectomy and fusion.

Methods: This retrospective study reviewed 61 patients who underwent anterior cervical discectomy and fusion for cervical spondylotic myelopathy at our institution. Patients were divided into two groups according to the treatment: polyether ether ketone cage with screws (Group S, n = 39) and titanium-coated polyether ether ketone cage with blades (Group B, n = 22). The primary outcome was the bone fusion rate at 6 months postoperatively. Secondary outcomes included operative time, intraoperative blood loss, retropharyngeal cavity width, wound pain, Japanese Orthopaedic Association scores, radiographic measurements, and cage subsidence.

Results: The bone fusion rate was higher in Group B (93.3 %) than in Group S (78.7 %), albeit not significantly (p = 0.077). Group B had significantly shorter operative times (107.7 ± 27.3 vs. 139.9 ± 50.1 min, p = 0.007) and lower blood loss (21.4 ± 20.5 vs. 42.1 ± 35.7 mL, p = 0.016). Group B also experienced significantly lesser wound pain on postoperative day 3 (2.0 ± 1.0 vs. 3.0 ± 1.3, p = 0.002). The retropharyngeal cavity width at C5 was significantly smaller in Group B on days 3 (6.3 ± 1.9 vs. 7.6 ± 1.6 mm, p = 0.004) and 7 (5.2 ± 2.5 vs. 6.9 ± 2.9 mm, p = 0.025). No significant between-group differences were noted in the retropharyngeal cavity width at C7, Japanese Orthopaedic Association scores, radiographic measurements, or cage subsidence.

Conclusion: Although the bone fusion rates were similar, the reduced surgical time and patient morbidity associated with graft harvesting suggest that titanium-coated polyether ether ketone cages with blades could improve patient care in anterior cervical discectomy and fusion.