Interim 1-Year Radiographic and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion Using Hydroxyapatite-Infused Polyetheretherketone Interbody Cages

Michael J Kelly; Bradley Gelfand; Kris Radcliff; Fred F Mo; Brox A Felix; S Babak Kalantar

doi:10.14444/8585

Interim 1-Year Radiographic and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion Using Hydroxyapatite-Infused Polyetheretherketone Interbody Cages

Int J Spine Surg. 2024 Feb 20:8585. doi: 10.14444/8585. Online ahead of print.

Authors

Michael J Kelly¹, Bradley Gelfand², Kris Radcliff³, Fred F Mo², Brox A Felix⁴, S Babak Kalantar²

Affiliations

¹ Hospital for Special Surgery, New York, NY, USA mjk266@georgetown.edu.
² MedStar Georgetown University Hospital, Washington, DC, USA.
³ Spinal DISC Center, Somers Point, NJ, USA.
⁴ Princeton University, Undergraduate Student, Princeton, NJ, USA.

PMID: 38378231
DOI: 10.14444/8585

Abstract

Background: This is a multicenter observational registry analysis of 1-year radiographic and clinical outcomes following anterior cervical discectomy and fusion (ACDF) using hydroxyapatite (HA)-infused polyetheretherketone (PEEK) intervertebral cages.

Methods: Radiographic and clinical outcome data were collected preoperatively and at 6 weeks, 3 months, 6 months, and 12 months postoperatively. To assess fusion, dynamic flexion-extension radiographs were independently evaluated with a validated method. Clinical outcomes were assessed using the following disease-specific measures: Neck Disability Index (NDI) and visual analog scale (VAS) for neck, left arm, and right arm pain. Patient satisfaction was also evaluated.

Results: A total of 789 ACDF patients (men: 51.5%/women: 48.5%; mean body mass index: 29.9 kg/m²) were included at the time of analysis, and 1565 segments have been operated. Successful fusion was confirmed in 91.3% of all operated levels after 6 months and 92.2% after 12 months. Mean NDI scores improved significantly (P < 0.01) preoperatively (46.3, n = 771) to postoperatively (12 months: 25.2, n = 281). Consistently, mean VAS neck (preoperative: 64.2, n = 770; 12 months: 28.6, n = 278), VAS right arm (preoperative: 42.6, n = 766; 12 months: 20.4, n = 277), and VAS left arm (preoperative: 41.1, n = 768; 12 months: 20.8, n = 277) decreased significantly (P < 0.01). Patients reported high satisfaction rates after surgery with no significant changes in postoperative patient satisfaction between 6 weeks and 12 months (95.1%, n = 273).

Conclusions: ACDF with HA-infused PEEK cages demonstrates promising radiographic and clinical outcomes, supporting the potential benefits of incorporating HA into PEEK cages to enhance fusion rates and improve patient outcomes.

Clinical relevance: This study demonstrates a >90% fusion rate by level with reliable improvements in patient reported outcomes, along with a high rate of patient satisfaction, in a large patient cohort undergoing ACDF with HA-infused PEEK cages.

Level of evidence: 2 .

Keywords: PEEK; cervical spine; hydroxyapatite; interbody fusion.

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