Introduction: To evaluate long term results after anterior cervical discectomy and fusion (ACDF) with stand-alone PEEK cages without osteogenic filling substance in patients with cervical myelopathy.
Methods: We performed a retrospective review of patients presenting with spondylotic cervical myelopathy und underwent anterior cervical discectomy and fusion (ACDF) with stand-alone PEEK cages without Osteogenic Filling Substance between 2007 and 2010 and had a minimum follow up of 12 months.
Results: 67 patients were found. The mean age at presentation was 68 years, 30 patients were male (44%). 31, 27 and 9 patients had one- two- and three-level surgeries, respectively.
46 (68%) patients presented with pain. Mild, moderate and severe myelopathy was observed in 73%, 16% and 11%, respectively.
Fusion was achieved in 97%, 96%, and 100 % levels in one-, two-, and three-level surgeries, respectively. Subsidence into the vertebral bodies of >3mm in one-, >5mm in two-, and >7mm in three-level surgery was observed in 22%, 18% and 14%, respectively.
The alignment of the whole cervical spine worsened in 18%, 22% and 57% in one two and three level surgeries, respectively. From the 46 patients presenting with pain, pain resolved or improved in 84% of cases. Mean VAS declined from 5.6 to 2, 5.2 to 2.4 and 5 to 1.25 in one-, two-, and three-level surgeries, respectively. Myelopathy improved in 64% of patients. Improvement or stability was observed in all dimensions of the EQ-5D in all surgery groups except for the dimension “Mobility” in the three level surgery group
Conclusions: One and two level ACDF with stand-alone PEEK cages without plates or the use of osteogenic filling substance achieved high fusion rates, high rate of alignment stability, and rare segmental instability. The rate of clinical improvement is satisfying. For three or more level ACDF the use of ventral plating is recommended to avoid cervical misalignment.
Patient Care: our research would help in deception making regarding the use stand-alone PEEK Cages in patients with cervical Myelopathy.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Discuss the clinical and radiological Outcome folioing ACDF for cervical Myelopathy