Korean J Neurotrauma.  2018 Oct;14(2):123-128. 10.13004/kjnt.2018.14.2.123.

Outcomes of Anterior Cervical Fusion Using Polyetheretherketone Cage with Demineralized Bone Matrix and Plate for Management of Subaxial Cervical Spine Injuries

• Han MS
• Lee GJ
• Kim JH
• Lee SK
• Moon BJ
• Lee JK

• KMID: 2424324
• DOI: http://doi.org/10.13004/kjnt.2018.14.2.123

Abstract

OBJECTIVE
We evaluated the usefulness of a polyetheretherketone (PEEK) cage filled with demineralized bone matrix (DBM) and plate fixation in anterior interbody fusions for subaxial cervical spine injuries.
METHODS
A retrospective review of 98 patients (58 women, 40 men; mean age, 49.7 years; range, 17-78 years) who underwent single-level anterior cervical discectomy and fusion (ACDF) using a PEEK cage filled with DBM and plate fixation for subaxial cervical spine injuries from March 2005 to June 2018 was conducted. Bone fusion, interbody height (IBH), segmental lordosis, and adjacent segment degeneration (ASD) development were assessed with plain radiographs and computed tomography. Clinical outcomes were assessed using a visual analog scale (VAS) for pain and the Frankel grade for neurologic function.
RESULTS
The mean follow-up period was 27.6 months (range, 6-142 months). Twenty-one patients (21.4%) had an improvement of at least one Frankel grade. The mean preoperative and final follow-up neck pain VAS scores were 8.3±0.9 and 2.6±1.5 (p < 0.05). All patients showed solid fusion at the final follow-up. The mean preoperative and final Cobb's angles were −3.7±7.9° and 1.9±5.1° (p < 0.05). The mean preoperative and final IBHs were 36.9±1.7 mm and 38.2±1.8 mm (p < 0.05). Five patients (5%) showed ASD.
CONCLUSION
ACDF using a PEEK cage filled with DBM and plate fixation yielded high fusion rates and satisfactory clinical outcomes without donor-site morbidity. This procedure is safe and effective for single-level subaxial cervical spine injuries.

Keyword

Anterior cervical discectomy and fusion; Cervical spine injury; Demineralized bone matrix; Polyetheretherketone

MeSH Terms

Animals
Bone Matrix*
Diskectomy
Female
Follow-Up Studies
Humans
Lordosis
Male
Neck Pain
Retrospective Studies
Spine*
Visual Analog Scale

Figure

• 

  FIGURE 1 Imaging studies of C4 and C5 anterior cervical discectomy and fusion (ACDF). (A) Simple cervical lateral radiograph shows C4 and C5 subluxation. (B) Immediate postoperative radiograph shows satisfactory stabilization of injured segment after C4 and C5 ACDF. (C) Last follow-up radiograph at 27 months after surgery shows satisfactory fusion at the C4 and C5 level. However, some degrees of subsidence and development of adjacent segmental degeneration (white arrow) were observed. (D) Last follow-up flexion-extension radiographs show also stabilization with less than 2 mm change in the posterior interspinous process distance at the C4 and C5 level.

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