Clinical and radiological outcomes of ACDF using titanium-screw PEEK cages: A retrospective series

Abstract

Objective

To evaluate the clinical and radiological outcomes of anterior cervical discectomy and fusion (ACDF) using titanium-screw PEEK cages, focusing on fusion rates, cervical alignment, pain relief, and complications.

Methods

Retrospective observational study of 40 consecutive patients treated between May 2017 and December 2018. Outcomes included Neck Disability Index (NDI), Numerical Rating Scale (NRS) for cervical and radicular pain, and radiological parameters (fusion status, Cobb angles, disk height). Complications were systematically documented, and longitudinal changes were analyzed using the Friedman test for repeated measures.

Results

At 2-year follow-up, all patients achieved radiological fusion (Bridwell grades I–II). Median NDI improved from 56% to 20% (p < 0.001). Cervical and radicular pain scores decreased significantly (median NRS from 8 to 2 and 7 to 1; p < 0.001). Cervical alignment and disk height improved and remained stable. Dysphagia and dysphonia occurred in 5% and 2.5% of cases, respectively, resolving spontaneously.

Conclusions

ACDF using titanium-screw PEEK cages is safe and effective, providing high fusion rates, significant clinical improvement, and low complication rates. These zero-profile hybrid devices offer a reliable alternative to traditional cage-plate constructs.