PEEK versus titanium-coated PEEK cervical cages: fusion rate

Area of Science:

• Spine surgery
• Orthopedic implants
• Degenerative cervical disease

Background:

• Anterior cervical discectomy and fusion (ACDF) is a common procedure for degenerative cervical disease.
• Standardization of fusion evaluation methods remains a challenge.
• This study compares fusion rates between two implant types.

Purpose of the Study:

• To evaluate and compare the fusion status of polyetheretherketone (PEEK) cages versus titanium-coated (TC) PEEK cages after ACDF.
• To determine if implant material influences fusion rates.
• To provide data for optimizing implant selection in ACDF procedures.

Main Methods:

• 170 disc spaces in 104 patients underwent ACDF using either PEEK or TC-PEEK cages, assigned randomly.
• Fusion status was assessed at 12 months post-surgery using functional radiographs and CT scans.
• Multivariate mixed-effects logistic regression models analyzed the association between implant type and fusion rates.

Main Results:

• Complete fusion was achieved in 71.1% of cases (101/144) at 12 months.
• PEEK cages demonstrated a complete fusion rate of 88.2% (75/85 disc spaces).
• TC-PEEK cages showed a complete fusion rate of 44.1% (26/59 disc spaces), significantly lower than PEEK implants (P < 0.0001).

Conclusions:

• Complete fusion rates at 12 months post-ACDF were significantly higher with PEEK implants compared to TC-PEEK implants.
• The choice of implant material impacts fusion outcomes in ACDF.
• Findings suggest PEEK cages may be more effective for achieving solid fusion in ACDF.