Radiological Outcome of Bony Fusion After Single-Level Anterior Cervical Discectomy and Fusion Using Iliac Crest Graft vs. Polyetheretherketone Cage in Cervical Spondylosis

Abstract

Objective: To compare the surgical outcome of iliac crest graft and polyetheretherketone in anterior cervical discectomy and fusion (ACDF) in cervical spondylosis in terms of radiographic features.

Materials & Methods:  It was a randomized controlled trial study in the Neurosurgery Department of Services Hospital, Lahore. Patients were recruited by non-probability, purposive sampling, followed by randomization by the lottery method and divided into two equal groups, i.e. (Group A) Iliac crest graft and (Group B) Polyetheretherketone cage.

Results: In this study, a total of 42 patients were included; 28(66.67%) patients were male, and 14(33.33%) were female, and having mean age ± SD 47.62±6.85 years, with a range of 35- 60 years. In group A, 21 patients underwent an iliac crest autograft, while in group B, 21 patients underwent a polyetheretherketone cage. In the 3^rd post-operative month, 7 patients (33.3%) with an iliac crest bone graft and 8 patients (38.1%) with a Polyetheretherketone cage had trabecular bone formation (p=0.747). In the 6th post-operative month, 6 patients (28.6%) with an iliac crest bone graft and 14 patients (66.7%) with a Polyetheretherketone cage had bridging bone formation (p=0.013). I

Conclusion: ACDF with a PEEK cage has better fusion results than an iliac crest graft in terms of radiographic features. Hence, the PEEK cage can be opted for in ACDF.