Anterior Cervical Fusion Using a Polyetheretherketone Cage Containing a Bovine Xenograftp Three to Five-Year Follow-up

Study Design. Retrospective review of an anterior polyetheretherketone (PEEK) cage incorporated with a bovine xenograft to treat disorders of the cervical disc. Objective. To assess the achievement of fusion by PEEK cage with xenograft radiographically and clinically when used to perform ACDF. Summary of Background Data. Anterior cervical discectomy and fusion is the therapy of choice for degenerative disc disorders of the cervical spine. Although cage device increases initial stability of the levels treated, fusion is the key factor for satisfactory results. Filling the cage devices with autologous iliac bone grafts enable achievement of the best fusion result. Although the volume of harvested bone graft is minimal, donor-site morbidity is still a complication of concern. To avoid this adverse issue, we used a new bovine xenograft in place of autologous bone graft. Methods. Fifty-six patients (33 men and 23 women aged 31-78 years) underwent anterior cervical discectomy and fusion using PEEK cage with a bovine xenograft bone substitute to treat symptomatic cervical disorders. Radiographic and clinical results were assessed over 3 to 5 years of follow up. Results. Almost all patients had symptomatic improvement, and 84% reported good-to-excellent satisfaction. All cases achieved solid fusion, confirmed by radiographs and computed tomography, but cage subsidence occurred at 8 levels. Conclusion. As applied in anterior cervical fusion, the cage incorporated with the xenograft prevented donor-site morbidity and provided successful fusion.