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. 2011:5:348-53.
doi: 10.2174/1874325001105010348. Epub 2011 Oct 7.

Polyetheretherketone (PEEK) Spacers for Anterior Cervical Fusion: A Retrospective Comparative Effectiveness Clinical Trial

Johannes Lemcke  1 , Ferass Al-Zain, Ullrich Meier, Olaf Suess
Affiliations

Polyetheretherketone (PEEK) Spacers for Anterior Cervical Fusion: A Retrospective Comparative Effectiveness Clinical Trial

Johannes Lemcke et al. Open Orthop J. 2011.

Abstract

Background: Anterior cervical decompression and fusion (ACDF) is the standard surgical treatment for radiculopathy and myelopathy. Polyetheretherketone (PEEK) has an elasticity similar to bone and thus appears well suited for use as the implant in ACDF procedures. The aim of this study is to examine the clinical and radiographic outcome of patients treated with standing alone PEEK spacers without bone morphogenic protein (BMP) or plating and to examine the influence of the different design of the two spacers on the rate of subsidence and dislocation.

Methods: This retrospective comparative study reviewed 335 patients treated by ACDF in a specialized urban hospital for radiculopathy or myelopathy due to degenerative pathologies. The Intromed PEEK spacer was used in 181 patients from 3/2002 to 11/2004, and the AMT SHELL spacer was implanted in 154 patients from 4/2004 to 12/2007. The follow-up rate was 100% at three months post-op and 82.7% (277 patients) at one year. The patients were assessed with the Japanese Orthopedic Association (JOA) questionnaire and radiographically.

Results: At the one-year follow-up there were 118/277 patients with an excellent clinical outcome on the JOA, 112/277 with a good outcome, 20/277 with a fair outcome, and 27/277 with a poor outcome. Subsidence was observed in 13.3% of patients with the Intromed spacer vs 8.4% of the patients with the AMT SHELL. Dislocation of the spacer was observed in 10 of the 181 patients with Intromed spacers but in none of the 154 patients with Shell spacers.

Conclusion: The study demonstrates that ACDF with standing alone PEEK cages leads to excellent and good clinical outcomes. The differences we observed in the subsidence rate between the two spacers were not significant and cannot be related to a single design feature of the spacers.

Keywords: ADCF; Anterior cervical decompression and fusion; PEEK spacer; dislocation.; subsidence.

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Figures

Fig. (1)
Fig. (1)
The Intromed PEEK spacer and the amt SHELL spacer.
Fig. (2)
Fig. (2)
Histogramms of the age distribution (left) and operated levels (right).
Fig. (3)
Fig. (3)
Histogramm of the heights of the implanted amt spacers (with retaining pins) and of the Intromed spacer (without retaining pins).
Fig. (4)
Fig. (4)
The Recovery-Rate directly postoperative, after 3 and 12 months for patients with the Intromed and the amt spacer shown as box-and-whisker plots.
Fig. (5)
Fig. (5)
The rates of subsidence and dislocation compared between Intromed spacer and amt spacer.
Fig. (6)
Fig. (6)
The rate of subsidence is drawn up against the height of the spacers.
See this image and copyright information in PMC

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