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Vertebral body replacement with PEEK-cages after anterior corpectomy in multilevel cervical spinal stenosis: a clinical and radiological evaluation

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

A growing number of industrially manufactured implants have been developed in the last years for vertebral replacement in anterior cervical corpectomy and fusion (ACCF). Polyetheretherketone (PEEK)-cages are used in many centers, but outcome reports are scarce. This study assesses the clinical and radiological outcome after one- or two-level ACCF by the use of a PEEK-cage augmented by a plate–screw osteosynthesis.

Methods

A total of 21 patients received one-level (18 patients) or two-level (3 patients) ACCF by a PEEK-cage and plate–screw osteosynthesis for multilevel degenerative stenosis. The Visual Analogue Scale, Nurick Score, Neck Disability Index and European Myelopathy Score were used for clinical assessment. Radiological outcome—osseous fusion and loss of height—was evaluated by CT.

Results

The mean follow-up was 28 ± 12 months. In 19 patients, bony fusion was achieved after the primary operation. Graft failure that required surgical revision occurred in two patients. In these patients, osseous fusion was achieved after the second operation. Myelopathy improved significantly. The loss of height was 2.2 ± 2.3 and 5.3 ± 2.1 mm after one- and two-level ACCF, respectively.

Conclusion

Anterior corpectomy and fusion by a PEEK-cage and plate–screw osteosynthesis resulted in clinical improvement in all patients. Bony fusion was achieved in all patients in the long run. PEEK cages are allegedly less rigid than other xenografts. Similar to those, however, their use bears the risk of early cage-dislocation and subsidence. A comparison of industrial xenografts and autologous bone implants is required to challenge the different fusion techniques.

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Acknowledgments

This work was not sponsored by private, industrial or governmental funding.

Conflict of interest

Dr. Westermaier received payments from Johnson & Johnson for teaching activities in spinal neurosurgery. None of the other authors has a conflict of interest to declare.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany

    Furat Raslan, Stefan Koehler, Stefan Rueckriegel, Ralf-Ingo Ernestus & Thomas Westermaier

  2. Department of Neurosurgery, Klinikum Hohe Warte, Bayreuth, Germany

    Furat Raslan

  3. Department of Neuroradiology, Krankenhaus Koeln-Merheim, Cologne, Germany

    Frank Berg

  4. Neurochirurgische Gemeinschaftspraxis Wuerzburg, Würzburg, Germany

    Matthias Meinhardt

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  1. Furat Raslan
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  2. Stefan Koehler
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  4. Stefan Rueckriegel
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Correspondence to Thomas Westermaier.

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Raslan, F., Koehler, S., Berg, F. et al. Vertebral body replacement with PEEK-cages after anterior corpectomy in multilevel cervical spinal stenosis: a clinical and radiological evaluation. Arch Orthop Trauma Surg 134, 611–618 (2014). https://doi.org/10.1007/s00402-014-1972-1

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  • DOI: https://doi.org/10.1007/s00402-014-1972-1

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