Purpose: This study aimed to compare clinical results and fusion rates of uncoated polyetheretherketone (PEEK) cages with titanium-coated PEEK cages in posterior lumbar interbody fusion (PLIF) surgery.
Methods: A prospective randomised study including 60 patients with one- or two-segment lumbar degenerative diseases. Patients received either titanium-coated PEEK cages (group A) or uncoated PEEK cages (group B). Fusion rates were evaluated on plain X-rays and CT scans after 6 and 12 months. Clinical follow-up (visual analogue scale, VAS; Oswestry Disability Index score, ODI; EQ-5D) was performed for 24 months.
Results: Fifty-five patients (92%) (36 female, 19 male) had a complete follow-up. There were no statistically significant differences in demographic, peri- or intraoperative data between groups A and B. ODI, VAS and EQ-5D improved significantly (p < 0.001) after surgery without statistically significant differences between the two groups. Overall, 65 operated segments could be evaluated for fusion (group A: 29 segments, group B: 36 segments, p = 0.6). Osseous integration of the cage surface improved significantly (p < 0.001) in both groups between 6 and 12 months after surgery. At 12-month follow-up, neither radiolucency nor signs of instability or dislocation were noted. Fusion was present in CT scans as follows: (a) bone growth through cage pores (A: 100%, B: 100%); (b) bone growth outside the cages (A: 48%, B: 61%; p = 0.3).
Conclusions: PEEK and titanium-coated PEEK cages for PLIF produce equally favourable clinical and radiological results up to 24 months post-surgery. The fusion rate was not different.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00586-020-06642-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
3D-printed porous titanium versus polyetheretherketone cages in lateral lumbar interbody fusion: a systematic review and meta-analysis of subsidence.
Front Med (Lausanne)
December 2024
Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Article Synopsis
- Cage subsidence can negatively affect lumbar fusion procedures, with material selection (PEEK vs. 3D-Ti) influencing this issue; the study aims to compare their subsidence rates.
- The systematic search reviewed 265 patients from three high-quality studies, focusing on cage subsidence and classified subsidence rates using a specific method.
- Results indicated that 3D-Ti cages have a significantly lower rate of subsidence compared to PEEK cages, with less severe subsidence and better overall performance.
Optimization of 3D-titanium interbody cage design. Part 1: in vitro biomechanical study of subsidence.
Spine J
December 2024
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona. Electronic address:
Background Context: Cage subsidence is a complication of interbody fusion associated with poor clinical outcomes. 3D-printed titanium interbody cages allow for the alteration of features such as stiffness and porosity. However, the influence of these features on subsidence and their biological effects on fusion have not been rigorously evaluated.
View Article and Find Full Text PDFEfficacy of Stand-Alone Anterior Lumbar Interbody Fusion With PEEK Cages, BMP-2, and Allografts for Treating Discogenic Low Back Pain: Assessing Clinical and Radiographic Outcomes.
Int J Spine Surg
November 2024
School of Medicine, Mercer University, Macon, Georgia, USA.
Background: Chronic low back pain secondary to degenerative disc disease is a significant public health issue worldwide, contributing to substantial health care burdens and patient disability. Anterior lumbar interbody fusion (ALIF) has emerged as a promising surgical solution, offering benefits such as disc height restoration, reduced neural compression, and improved spinal alignment. This study evaluates the efficacy of stand-alone ALIF using polyetheretherketone (PEEK) cages, structural femoral head allografts, and recombinant human bone morphogenetic protein-2 (rhBMP-2) in treating discogenic low back pain caused by degenerative disc disease.
View Article and Find Full Text PDFStructural design and biomechanical analysis of a combined titanium and polyetheretherketone cage based on PE-PLIF fusion.
Med Biol Eng Comput
October 2024
Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Article Synopsis
- The study explores the biomechanical performance of a newly designed spinal fusion cage compared to traditional titanium and PEEK cages, highlighting the drawbacks of stress shielding and poor bone ingrowth associated with the former materials.
- Using finite element analysis, the new combined cage showed a 9.5% increase in strain capacity and reduced endplate and fusion stresses by 12% and 17%, respectively, during dynamic movements.
- The findings indicate that the combined cage may improve fusion stability and reduce adverse effects tied to titanium cages, offering insights for better clinical cage designs in spinal fusion surgeries.
Effect of Cage Material and Size on Fusion Rate and Subsidence Following Biportal Endoscopic Transforaminal Lumbar Interbody Fusion.
Neurospine
September 2024
Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Objective: Biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF) is an emerging, minimally invasive technique performed under biportal endoscopic guidance. However, concerns regarding cage subsidence and sufficient fusion during BE-TLIF necessitate careful selection of an appropriate interbody cage to improve surgical outcomes. This study compared the fusion rate, subsidence, and other radiographic parameters according to the material and size of the cages used in BE-TLIF.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!