Abstract
Background: The aim of the present study was to compare whether anterior cervical discectomy and fusion (ACDF) with a polyether ether ketone (PEEK) cage was superior to anterior cervical corpectomy and fusion (ACCF) with a titanium mesh cage (TMC) in the treatment of two-adjacent-level cervical degenerative disease.
Methods: From May 2014 to December 2015, 47 patients with cervical degenerative disease who underwent ACDF with PEEK or ACCF with TMC were included in this retrospective analysis. Perioperative parameters (hospital stay, blood loss, operation time, and complications), clinical outcomes (Japanese Orthopaedic Association scores and visual analogue scale scores for neck and arm pain), and radiological outcomes (the overall cervical sagittal angle, segmental angle of the treated vertebral level, the height of the treated vertebral level, and fusion status) were evaluated.
Results: The operative time was significantly shorter (P = 0.006) and blood loss was higher (P = 0.081) in the ACCF with TMC group. The early hardware failure rate was 4% and 0% in the ACCF with TMC group and the ACDF with PEEK group, respectively. The subsidence rate was higher in the ACCF with TMC group (8%) than in the ACDF with PEEK group (0%).
Conclusions: The two procedures yielded comparable results in terms of clinical and radiological outcomes during 1-year follow-up. However, when compression at the vertebral level is mild to moderate, we suggest the use of ACDF than ACCF because of the possibility of early hardware failure. Allograft or heterotopic autograft can be avoided in both groups.
Three-level Anterior Cervical Discectomy and Fusion for the Cervical Degenerative Disease
