PT  - JOURNAL ARTICLE
AU  - Franziska C.S. Altorfer
AU  - Christoph J. Laux
AU  - Dimitri Graf
AU  - Tobias Götschi
AU  - Frederik Abel
AU  - Mazda Farshad
AU  - José M. Spirig
TI  - Titanium-Coated Polyetheretherketone Cages Vs Full Titanium Cages for Stand-Alone 1- or 2-Level Anterior Cervical Discectomy and Fusion: A Comparative Study
AID  - 10.14444/8610
DP  - 2024 Jun 01
TA  - International Journal of Spine Surgery
PG  - 287--294
VI  - 18
IP  - 3
4099  - https://www.ijssurgery.com/content/18/3/287.short
4100  - https://www.ijssurgery.com/content/18/3/287.full
SO  - Int J Spine Surg2024 Jun 01; 18
AB  - Background Anterior cervical discectomy and fusion (ACDF) for the surgical treatment of cervical degenerative disease often includes an intervertebral cage, which restores disc height and lordosis while promoting fusion . Cage materials include titanium (TTN) or polyetheretherketone (PEEK). Controversy in material selection stems from higher fusion rates with TNN, despite a higher subsidence rate, while PEEK cages demonstrate superior preservation of interspace height. Combining the advantages of both materials, TTN-coated PEEK (TCPEEK) cages were developed, featuring a PEEK core with similar stiffness to the bone, enveloped with a TTN coat, improving osteointegration. However, the potential superiority of TCPEEK over TTN cages has not been investigated. This study aimed to compare clinical and radiographic outcomes following single- or double-level ACDF using either TTN or TCPEEK cages.Methods This retrospective single-center study included patients undergoing single- or double-level ACDF between 2017 and 2019. Clinical outcomes included the Neck Disability Index and revision surgery incidence. Radiographic parameters included cervical and segmental lordosis, C2 to C7 sagittal vertical axis, fusion, subsidence, and adjacent segment degeneration at a minimum 12-month follow-up.Results A total of 45 patients (16 TTN; 29 TCPEEK) and 58 cervical levels (21 TTN; 37 TCPEEK) were included. Both cages significantly improved Neck Disability Index scores (TTN −10.0; TCPEEK −14.1) without significant differences. Two single-level TCPEEK patients required revision surgery due to non-union. In the radiological assessments, no significant difference was found for subsidence rates (TTN 52.4%; TCPEEK 56.8%), adjacent segment degeneration, cervical and segmental lordosis, and changes in C2 to C7 sagittal vertical axis. Though not statistically significant, fusion rates trended slightly higher with TTN (90.5%) vs TCPEEK cages (86.5%).Conclusion TTN and TCPEEK cages achieve satisfactory clinical and radiological outcomes in single- or double-level ACDF. This finding suggests that the choice between them can be based on other factors, such as surgeon preference or availability, rather than specific material properties.Clinical Relevance This study found that the selection of ACDF cage material did not affect clinical outcomes.Level of Evidence 3.