Show pageBacklinksCite current pageExport to PDFBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. ====== Cervical PEEK Cage ====== {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1RiS31tjBXJqJEl9-w4aAKs1oLKbaSyLTpUx_3bLvV-BB2OITc/?limit=15&utm_campaign=pubmed-2&fc=20240221174153}} ===== Hydroxyapatite-infused cervical PEEK cage ===== [[Hydroxyapatite-infused cervical PEEK cage]]. ===== Cervical Titanium Cage ===== [[Cervical Titanium Cage]]. ---- {{ cervical-peek.jpg?200}} 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]]. A study provided strong evidence that ACDF is effective treatment, but the overall rate of radiographic fusion with empty PEEK cages is slow and insufficient. Lack of complete radiographic fusion leads to less improvement of pain and disability. The study recommended against using empty uncoated pure PEEK cages in ACDF ((Suess O, Schomaker M, Cabraja M, Danne M, Kombos T, Hanna M. Empty polyetheretherketone (PEEK) cages in anterior cervical diskectomy and fusion (ACDF) show slow radiographic fusion that reduces clinical improvement: results from the prospective multicenter "PIERCE-PEEK" study. Patient Saf Surg. 2017 Apr 28;11:12. doi: 10.1186/s13037-017-0128-y. eCollection 2017. PubMed PMID: 28465721; PubMed Central PMCID: PMC5410058. )). ---- Studies comparing [[cervical titanium cage]]s and PEEK cages are rare in the literature. Chou’s team retrospectively compared the results of anterior cervical fusion using titanium cages, PEEK cages and tricortical bone grafts ((Chou YC, Chen DC, Hsieh WA, Chen WF, Yen PS, Harnod T, Chiou TL, Chang YL, Su CF, Lin SZ, Chen SY. Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts. J Clin Neurosci. 2008 Nov;15(11):1240-5. doi: 10.1016/j.jocn.2007.05.016. Epub 2008 Sep 17. PubMed PMID: 18801658. )). They noticed a better fusion rate and less subsidence in the PEEK cages group. However, the study only enrolled a small number of patients and cervical spinal function was not evaluated. In a systematic review by Kersten who compared a PEEK cage with a bone graft, titanium cage, and carbon fiber cage, no difference was found between PEEK and titanium cage ((Kersten RF, van Gaalen SM, de Gast A, Öner FC. Polyetheretherketone (PEEK) cages in cervical applications: a systematic review. Spine J. 2015 Jun 1;15(6):1446-60. doi: 10.1016/j.spinee.2013.08.030. Epub 2013 Dec 27. Review. PubMed PMID: 24374100. )). A [[meta-analysis]] indicated no significant difference in functional and radiographic performance between the [[PEEK]] and [[titanium cage]]s, although more subsidence occurred in the titanium cage group. More high-quality studies are needed to confirm these results to offer more information for the choice in clinical practice ((Li ZJ, Wang Y, Xu GJ, Tian P. Is PEEK cage better than titanium cage in anterior cervical discectomy and fusion surgery? A meta-analysis. BMC Musculoskelet Disord. 2016 Sep 1;17:379. doi: 10.1186/s12891-016-1234-1. PubMed PMID: 27585553; PubMed Central PMCID: PMC5009677. )). ---- A study 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 [[graft]]s made of [[allogeneic bone]] versus [[PEEK]]. 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-squared 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. )). ---- The aim of a study is to compare [[silicon nitride]] implants with [[PEEK]] cages filled with autograft harvested from osteophytes. A prospective, randomized, blinded study of 100 patients with 2 years follow-up. The primary outcome measure was improvement in the Neck Disability Index. Other outcome measures included SF-36, [[VAS]] arm pain, VAS neck pain, assessment of recovery, operative characteristics, complications, fusion and subsidence based on dynamic X-ray and CT scan. There was no significant difference in [[NDI]] scores between the groups at 24 months follow-up. At 3 and 12 months the NDI scores were in favor of PEEK although the differences were not clinically relevant. On most follow-up moments there was no difference in VAS neck and VAS arm between both groups, and there was no statistically significant difference in patients' perceived recovery during follow-up. Fusion rate and subsidence were similar for the two study arms and about 90% of the implants were fused at 24 months. Patients treated with silicon nitride and PEEK reported similar recovery rates during follow-up. There was no significant difference in clinical outcome at 24 months. Fusion rates improved over time and are comparable between both groups ((Arts MP, Wolfs JF, Corbin TP. Porous silicon nitride spacers versus PEEK cages for anterior cervical discectomy and fusion: clinical and radiological results of a single-blinded randomized controlled trial. Eur Spine J. 2017 Apr 5. doi: 10.1007/s00586-017-5079-6. [Epub ahead of print] PubMed PMID: 28382392. )). ===== Cages ===== Aleutian, Stryker, MI, USA [[AVS Anchor-C]] Aves Cervical Bladed Peek Cage http://www.ledamed.com AYERS ROCK Spineway France CAP Cervical H.P.I. Medical France CERAF ARCA-MEDICA Germany cerv-X™ CERVICAL PEEK CAGE http://www.implantint.net/ CeSPACE® PEEK Cervical PEEK cage Coroent http://www.goldengatevn.com/ Coalition, Globus Medical, PA, USA Genoss Integral Cervical Cage™ LorX® Expandable Cervical Peek Cage with Blade PROYSTER® Prodorth Reborn® Cervical PEEK Cage http://www.meditechimplant.com ROI-C cervical cage (LDR) [[Samarys]] SAS 9® Biotechni France SOURIRE ARCA-MEDICA Germany Velofix http://www.youic.com/ Zero P (Synthes, Inc.).... ===== Case series ===== see [[Cervical PEEK Cage case series]] ===== References ===== cervical_peek_cage.txt Last modified: 2024/06/07 02:56by 127.0.0.1