Porous silicon nitride spacers versus PEEK cages for anterior cervical discectomy and fusion: clinical and radiological results of a single-blinded randomized controlled trial.

Abstract

PURPOSE:

Anterior cervical discectomy with fusion is a common procedure for treating radicular arm pain. Polyetheretherketone (PEEK) plastic is a frequently used material in cages for interbody fusion. Silicon nitride is a new alternative with desirable bone compatibility and imaging characteristics. The aim of the present study is to compare silicon nitride implants with PEEK cages filled with autograft harvested from osteophytes.

METHODS:

The study is a prospective, randomized, blinded study of 100 patients with 2 years follow-up. The primary outcome measure was improvement in the Neck Disability Index. Other outcome measures included SF-36, VAS arm pain, VAS neck pain, assessment of recovery, operative characteristics, complications, fusion and subsidence based on dynamic X-ray and CT scan.

RESULTS:

There was no significant difference in NDI scores between the groups at 24 months follow-up. At 3 and 12 months the NDI scores were in favor of PEEK although the differences were not clinically relevant. On most follow-up moments there was no difference in VAS neck and VAS arm between both groups, and there was no statistically significant difference in patients' perceived recovery during follow-up. Fusion rate and subsidence were similar for the two study arms and about 90% of the implants were fused at 24 months.

CONCLUSIONS:

Patients treated with silicon nitride and PEEK reported similar recovery rates during follow-up. There was no significant difference in clinical outcome at 24 months. Fusion rates improved over time and are comparable between both groups.

• Authors: Mark P Arts, Jasper F C Wolfs, Terry P Corbin
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 26 Issue 9 Pg. 2372-2379 (Sep 2017) ISSN: 1432-0932 [Electronic] Germany
• PMID: 28382392 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Benzophenones
• Biocompatible Materials
• Ketones
• Polymers
• Silicon Compounds
• polyetheretherketone
• Polyethylene Glycols
• silicon nitride

Topics

• Adult
• Aged
• Benzophenones
• Biocompatible Materials
• Bone Transplantation (methods)
• Cervical Vertebrae (diagnostic imaging, surgery)
• Disability Evaluation
• Diskectomy (adverse effects, instrumentation, methods)
• Female
• Humans
• Intervertebral Disc Displacement (diagnostic imaging, surgery)
• Ketones
• Male
• Middle Aged
• Neck Pain (diagnostic imaging, surgery)
• Osteophyte (surgery)
• Pain Measurement (methods)
• Polyethylene Glycols
• Polymers
• Prospective Studies
• Prostheses and Implants
• Radiography
• Silicon Compounds
• Single-Blind Method
• Spinal Fusion (adverse effects, instrumentation, methods)
• Treatment Outcome
• Young Adult