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Comparison of Post-Operative Lordosis with the PEEK Cage and the Cervical Plate

Published online by Cambridge University Press:  02 December 2014

Jeffrey S. Wilkinson ,
Sumeer A. Mann ,
Grant W. Stoneham ,
Stephen Hentschel  and
Daryl R. Fourney
Jeffrey S. Wilkinson
Affiliation:
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan
Sumeer A. Mann
Affiliation:
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan
Grant W. Stoneham
Affiliation:
Department of Diagnostic Imaging, University of Saskatchewan, Saskatoon, Saskatchewan
Stephen Hentschel
Affiliation:
Division of Neurosurgery, Victoria, British Columbia, Canada
Daryl R. Fourney*
Affiliation:
Division of Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan
*
Division of Neurosurgery, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8, Canada
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Abstract:

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Objective:

The maintenance of post-operative lordosis has been shown to be a key factor in decreasing adjacent level disc stress. Previous studies of the PEEK (polyetherether ketone) cage have used intervertebral bony fusion as the primary measure of surgical success; however, little is known about its effects on spinal curvature. Our objective was to compare the PEEK cage to the cervical plate with respect to the maintenance of cervical lordosis at one year. Secondary outcomes included fusion and complication rates.

Methods:

We performed a retrospective study of patients who underwent ACDF (anterior cervical discectomy and fusion) by two different methods; 13 patients were treated with the PEEK cage, and 22 with allograft and plating.

Results:

Patient and treatment characteristics were similar in both groups. Average global lordotic curvature (C2-C7) was increased by 1.7 degrees for the PEEK cage and decreased by 1.6 degrees for the plate after an average follow-up of 12.46 and 14.95 months, respectively. Regional lordosis for the PEEK cage and plate was decreased by 2.5 and 2.1 degrees, respectively for the same time period. These differences did not achieve statistical significance. Bony fusion was observed in all patients. One patient in each group developed persistent mild dysphagia.

Conclusions:

The PEEK cage is comparable to the anterior cervical plate in the maintenance of post-operative cervical lordosis.

Résumé:

Résumé:Objectif:

Il est bien connu que le maintien de la lordose post-opératoire est un facteur important pour diminuer le stress sur les disques des niveaux adjacents. Des études antérieures de la cage en PEEK (polyétheréthercétone) ont utilisé la fusion osseuse intervertébrale comme mesure primaire du succès chirurgical. Cependant, on sait peu de choses à propos de ses effets sur la courbature spinale. Notre objectif était de comparer la cage en PEEK à la plaque d'ostéosynthèse cervicale quant au maintien de la lordose cervicale un an plus tard. Les critères d'évaluation secondaires comprenaient la fusion et les taux de complications.

Méthodes:

Nous avons effectué une étude rétrospective des patients qui ont subi une discectomie avec fusion cervicale antérieure par deux méthodes différentes: 13 patients ont été traités au moyen de la cage en PEEK et 22 ont reçu une allogreffe avec pose d'une plaque d'ostéosynthèse.

Résultats:

Les caractéristiques des patients et du traitement étaient les mêmes dans les deux groupes. La courbature lordotique globale moyenne (C2-C7) était de 1,7 degré plus élevée dans le groupe chez qui la cage en PEEK avait été utilisée et diminuée de 1,6 degré dans le groupe chez qui une plaque d'osthéosynthèse avait été utilisée après un suivi moyen de 12,46 et de 14,95 mois respectivement. La lordose régionale était diminuée de 2,5 degrés dans le premier groupe et de 2,1 degrés dans le deuxième groupe après cette durée de suivi. Ces différences n'étaient pas significatives à l'analyse statistique. Tous les patients présentaient une fusion osseuse. Un patient de chaque groupe a présenté une dysphagie légère.

Conclusions:

La cage en PEEK est comparable à la pose d'une plaque d'ostéosynthèse cervicale antérieure pour le maintien de la lordose cervicale après la chirurgie.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 1 , January 2011 , pp. 72 - 77
Copyright
Copyright © Canadian Neurological Sciences Federation 2011

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