PEEK Cages versus Titanium-Coated PEEK Cages in Single-Level Anterior Cervical Fusion: A Randomized Controlled Study.

Area of Science:

• Spine surgery
• Biomaterials science
• Orthopedic research

Background:

• Anterior cervical discectomy often involves interbody spacer implantation.
• Polyether ether ketone (PEEK) cages are preferred over titanium for imaging but may have higher nonunion rates.
• Titanium-coated PEEK (TiPEEK) cages are an alternative to standard PEEK.

Purpose of the Study:

• To compare the fusion rates of plain PEEK cages versus TiPEEK cages after anterior cervical discectomy.
• To evaluate the clinical outcomes and fusion behavior of TiPEEK compared to PEEK.
• To determine if TiPEEK offers advantages in cervical spine fusion.

Main Methods:

• A prospective randomized controlled study involving 104 patients with single-level cervical radiculopathy or myelopathy.
• Patients were randomized to receive either a PEEK cage or a TiPEEK cage.
• Fusion was assessed using X-ray and functional X-ray at 1- and 2-year follow-ups.

Main Results:

• At 2 years, fusion rates were 86% for PEEK and 82% for TiPEEK (p=0.59), with no significant difference.
• Six nonunions occurred in the PEEK group and nine in the TiPEEK group.
• No significant differences in neurologic examination or pain scores were observed between the groups.

Conclusions:

• TiPEEK cages do not demonstrate an accelerated or improved fusion rate compared to standard PEEK cages in anterior cervical discectomy.
• The study did not support the assumption that TiPEEK offers superior fusion performance.
• Clinical outcomes were similar for both PEEK and TiPEEK cages in this cohort.