Allograft Implant [Neurosurgery Wiki]

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====== Allograft Implant ======

[[Anterior cervical discectomy and fusion]] is commonly performed using an [[allograft]] or [[autograft]] [[implant]] and anterior screw-supported plate.
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Common [[interbody graft]] options for [[anterior cervical discectomy and fusion]] (ACDF) include structural [[allograft]] and [[polyetheretherketone]] ([[PEEK]]). PEEK has gained popularity due to its radiolucency and its elastic modulus, which is similar to that of [[bone]]. 

The authors sought to compare the rates of [[pseudarthrosis]], a lack of solid bone growth across the disc space, and the need for [[revision surgery]] with the use of grafts made of [[allogeneic bone]] versus PEEK.

The authors retrospectively reviewed 127 cases in which patients had undergone a 1-level [[ACDF]] followed by at least 1 year of radiographic follow-up. Data on age, sex, [[body mass index]], [[tobacco]] use, [[pseudarthrosis]], and the [[reoperation]] rate for pseudarthrosis were collected. These data were analyzed by performing a Pearson's chi-square test.

Of 127 patients, 56 had received PEEK implants and 71 had received [[allograft]]s. Forty-six of the PEEK implants (82%) were stand-alone devices. There were no significant differences between the 2 treatment groups with respect to patient age, sex, or body mass index. Twenty-nine (52%) of 56 patients with PEEK implants demonstrated radiographic evidence of [[pseudarthrosis]], compared to 7 (10%) of 71 patients with structural allografts (p < 0.001, OR 9.82; 95% CI 3.836-25.139). Seven patients with PEEK implants required reoperation for pseudarthrosis, compared to 1 patient with an allograft (p = 0.01, OR 10.00; 95% CI 1.192-83.884). There was no significant difference in tobacco use between the PEEK and allograft groups (p = 0.586).

The results of this study demonstrate that the use of PEEK devices in 1-level ACDF is associated with a significantly higher rate of radiographically demonstrated pseudarthrosis and need for revision surgery compared with the use of [[allograft]]s. Surgeons should be aware of this when deciding on interbody graft options, and [[reimbursement]] policies should reflect these discrepancies
((Fivefold higher rate of pseudarthrosis with polyetheretherketone interbody
device than with structural allograft used for 1-level anterior cervical
discectomy and fusion. J Neurosurg Spine. 2018 Oct 1:1-6. doi:
10.3171/2018.7.SPINE18531. [Epub ahead of print] PubMed PMID: 30485200.
)).