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PLIF surgery with titanium-coated PEEK or uncoated PEEK cages: a prospective randomised clinical and radiological study

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Abstract

Purpose

This study aimed to compare clinical results and fusion rates of uncoated polyetheretherketone (PEEK) cages with titanium-coated PEEK cages in posterior lumbar interbody fusion (PLIF) surgery.

Methods

A prospective randomised study including 60 patients with one- or two-segment lumbar degenerative diseases. Patients received either titanium-coated PEEK cages (group A) or uncoated PEEK cages (group B). Fusion rates were evaluated on plain X-rays and CT scans after 6 and 12 months. Clinical follow-up (visual analogue scale, VAS; Oswestry Disability Index score, ODI; EQ-5D) was performed for 24 months.

Results

Fifty-five patients (92%) (36 female, 19 male) had a complete follow-up. There were no statistically significant differences in demographic, peri- or intraoperative data between groups A and B. ODI, VAS and EQ-5D improved significantly (p < 0.001) after surgery without statistically significant differences between the two groups. Overall, 65 operated segments could be evaluated for fusion (group A: 29 segments, group B: 36 segments, p = 0.6). Osseous integration of the cage surface improved significantly (p < 0.001) in both groups between 6 and 12 months after surgery. At 12-month follow-up, neither radiolucency nor signs of instability or dislocation were noted. Fusion was present in CT scans as follows: (a) bone growth through cage pores (A: 100%, B: 100%); (b) bone growth outside the cages (A: 48%, B: 61%; p = 0.3).

Conclusions

PEEK and titanium-coated PEEK cages for PLIF produce equally favourable clinical and radiological results up to 24 months post-surgery. The fusion rate was not different.

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Acknowledgement

We would like to thank our colleagues Stephan Weil, Wolfgang Dube, and Sarah Winkelkotte for their invaluable support for this study.

Funding

This study was supported with a financial grant by Advanced Medical Technologies AG, Germany.

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Authors and Affiliations

  1. Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Rathsberger Strasse 57, 91054, Erlangen, Germany

    Klaus John Schnake

  2. Orthopaedicum Frankfurt, Frankfurt am Main, Germany

    Nikolai Fleiter

  3. Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt, Frankfurt am Main, Germany

    Christoph Hoffmann, Andreas Pingel, Matti Scholz & Frank Kandziora

  4. Department of Diagnostic and Interventional Radiology, BG Unfallklinik Frankfurt, Frankfurt am Main, Germany

    Alexander Langheinrich

Authors
  1. Klaus John Schnake
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  2. Nikolai Fleiter
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  4. Andreas Pingel
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  5. Matti Scholz
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  7. Frank Kandziora
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Correspondence to Klaus John Schnake.

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Dr. Schnake received renumeration for consulting from Advanced Medical Technology AG, Germany. The other authors report no conflict of interest.

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Schnake, K.J., Fleiter, N., Hoffmann, C. et al. PLIF surgery with titanium-coated PEEK or uncoated PEEK cages: a prospective randomised clinical and radiological study. Eur Spine J 30, 114–121 (2021). https://doi.org/10.1007/s00586-020-06642-x

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  • DOI: https://doi.org/10.1007/s00586-020-06642-x

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