Background; Although autologous bone grafts harvested from iliac crest were used since the early days of ACDF, they caused donor site morbidities. PEEK cages used in cervical spine surgeries on a wide scale with controversy of their filling material.
This study is to evaluate bone fusion and clinical outcome of one level ACDF using stand-alone PEEK cage filled with Biphasic Calcium Phosphate granules in treatment of degenerative CDD
Methods: A prospective study, where patients with single level degenerative CDD, underwent ACDF using our technique from April 2017 to April 2019 with one year follow up. Preoperative and one-year postoperative Visual Analog Scale (VAS) for neck pain and arm pain assessed. One-year postoperative Odom clinical outcome scoring system, Patient Satisfaction Index (PSI) and bone fusion assessed. Bone fusion considered successful if bridging bone incorporating graft and adjoining vertebral endplates was apparent.
Results: 19 patients included, 14 female patients (73.68%) and 5 male patients (26.32%). The preoperative mean VAS for neck pain and arm pain improved from 7.37±1.74 and7.96 ±1.24 to 2.95±1.27 and 2.21 ±1.01 respectively. This difference found statistically significant. According to Odom scoring system, 15 patients (78.95%) had excellent outcome and 4 patients (21.05%) had good outcome and by using PSI, 16 patients (84.21%) were grade 1 and 3 patients (15.79%) were grade 2. 17 patients (89.47 %) showed bone fusion, while 2 patients (10.53 %) showed non-union.
Conclusion: we found our technique safe and effective alternative with bone fusion and clinical outcome comparable to those of other options.
Key words; Anterior cervical discectomy; PEEK cage; Biphasic calcium phosphate.