Evaluation of polytheretherketone (PEEK) cages in surgical treatment of multilevel cervical degenerative disease

Anterior Cervical Discectomy and Fusion (ACDF) with autograft spacer is a traditional surgical treatment option to correct cervical degenerative disc disease and maintain intradiscal height. There is not a clear consensus on what type of interbody spacer is the best treatment option for patients undergoing ACDFs, so this study seeks to mitigate the gap in available literature. The aim of this retrospective study is to evaluate the clinical findings and radiographic outcomes in ACDFs using polytheretherketone (PEEK) cages in the surgical treatment of multilevel cervical degenerative disease between C2 and T1. We examined 72 consecutive patients with degenerative cervical disorder from C2-T1 who underwent ACDFs with PEEK cages between 06/01/19 and 05/05/21. The collected measures were pain levels using the Visual Analog Scale (VAS), intraoperative and postoperative (post-op) complications, and radiographic outcomes. The average VAS score was 5.7 out of 10 preoperatively (pre-op), 3.5 out of 10 two weeks post-op, 2.4 out of 10 three months post-op, and 3.06 out of 10 six months post-op. Pre-op symptoms were resolved in 69 out of 72 patients (95.8%). Durotomies were observed in 4 out of 72 (5.6%) patients intraoperatively. Post-op complications included dysphagia (13.9%), wound healing (12.5%), cervical hematoma (0%), hoarseness (0%), cerebrospinal fluid leak (0%), infection (0%), and death (0%). Spinal fusions were seen in 65 out of 72 patients (90%) over a six-month period. While there were no abnormal instrumentations noted, malalignment was observed in 2 out of 72 patients (2.8%). None of the patients required revision spinal surgery. Most of the patients experienced an improvement of pain and relief of symptoms post-op. A majority of individuals achieved fusion with minimal complications. This study suggests that PEEK can be a viable interbody spacer in multilevel ACDFs for the treatment of individuals with degenerative cervical disorders. Additional evaluations of different interbody spacers can confirm these findings to identify the most effective spacer that will yield optimal patient outcomes