Titanium-interlayer mediated hydroxyapatite coating on polyetheretherketone: a prospective study in patients with single-level cervical degenerative disc disease

Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle(C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. In conclusion, in patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both of the two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

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Titanium-interlayer Mediated Hydroxyapatite Coating on Polyetheretherketone: A Prospective Study in Patients with Single-level Cervical Degenerative Disc Disease

10.26434/chemrxiv.13265312.v1 ◽

2020 ◽

Author(s):

Ce zhu ◽

Miaomiao He ◽

Lili Mao ◽

Tao LI ◽

Li Zhang ◽

...

Keyword(s):

Degenerative Disc Disease ◽

Fusion Rate ◽

Peek Cage ◽

Disc Disease ◽

Degenerative Disc ◽

Single Level ◽

Cervical Degenerative Disc Disease ◽

Post Operation

Currently, there are limited reports regarding investigation of the biological properties of polyetheretherketone (PEEK) coated with titanium (Ti) and hydroxyapatite (HA) in human. The objective of this study is to evaluate the in vivo response of the PEEK cages coated with Ti and HA versus uncoated PEEK cages after anterior cervical discectomy and fusion (ACDF) in patients with single-level cervical degenerative disc disease (CDDD). Twenty-four patients with PEEK cages coated with Ti and HA (PEEK/Ti/HA group) were matched one-to-one with patients with uncoated PEEK cages (PEEK group) based on age, gender, and operative segment. All patients had been followed up for more than 2 years. Radiological assessments included intervertebral height (IH), C2-7 angle(C2-7a), segmental alignment (SA), and fusion rate. Clinical parameters included Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) scores. There was no statistical difference in SA, IH, and C2-7a between the two groups before and after surgery and all these parameters were restored postoperatively. The fusion rate of PEEK/Ti/HA group was significantly higher than PEEK group at 3-month post-operation (87.5% vs. 62.5%). At the last follow-up, the fusion rate of the both groups achieved 100%. The VAS and JOA scores were comparable between two groups and improved postoperatively. In conclusion, in patients with single-level ACDF, PEEK cage coated with Ti and HA provided a higher fusion rate than uncoated PEEK cage at 3-month post-operation, while both of the two cages could achieve solid osseous fusion at the last follow up. Compared with the uncoated PEEK cage, PEEK/Ti/HA cage yielded similar favorable segmental and overall cervical lordosis, IH, and clinical outcomes after the surgery.

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Comparison of dynamic cervical implant versus anterior cervical discectomy and fusion for the treatment of single-level cervical degenerative disc disease: A five-year follow-up

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2017.12.001 ◽

2018 ◽

Vol 164 ◽

pp. 103-107 ◽

Cited By ~ 6

Author(s):

Ce Zhu ◽

Xi Yang ◽

Lei Wang ◽

Bo-wen Hu ◽

Li-min Liu ◽

...

Keyword(s):

Degenerative Disc Disease ◽

Anterior Cervical Discectomy ◽

Disc Disease ◽

Cervical Discectomy ◽

Degenerative Disc ◽

Single Level ◽

Dynamic Cervical Implant ◽

Cervical Degenerative Disc Disease

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The Functional outcome following anterior cervical discectomy and fusion for single level cervical degenerative disc disease: a prospective single institutional study

Nepal Journal of Neuroscience ◽

10.3126/njn.v17i2.30164 ◽

2020 ◽

Vol 17 (2) ◽

pp. 42-47

Author(s):

Somraj Lamichhane ◽

Sujata Panta ◽

Devendra Acharya

Keyword(s):

Degenerative Disc Disease ◽

Cervical Spondylotic Myelopathy ◽

Anterior Cervical Discectomy ◽

Disc Disease ◽

Cervical Discectomy ◽

Degenerative Disc ◽

Single Level ◽

Cervical Degenerative Disc Disease ◽

Severe Grade

Introduction: Cervical degenerative disc diseases leading to cervical spondylotic myelopathy (CSM) is one the most common cause of disability in elderly population that progresses with age with continuation of degree of degeneration. Objective: To assess the functional outcome following ACDF in single-level cervical degenerative disc disease in terms of improvement in the mJOA scoring system and postoperative complications. Materials and methods: Eighteen patients with single level cervical degenerative disc diseases who presented at the college of medical sciences from May 2018 to October 2019 fulfilling the inclusion criteria (single-level cervical degenerative disc disease with age between 40 to 70 years with progressive neurological deficits, features of cervical spondylotic myelopathy and patients with mild grade who failed four weeks of conservative treatment and progressed to moderate or severe grades) were included in the study. All patients underwent Anterior Cervical Discectomy and Fusion (ACDF); with tricortical iliac crest graft with cervical plate and screws in 13 patients and polyether ether ketone (PEEK) cage placement in five patients. Patients were assessed using mJOA scoring system and graded into mild, moderate and severe myelopathy. Post-operatively patients were assessed for improvement in terms of mJOA scores at four weeks and three months follow-up. They were also assessed for development of any post-operative complications and documented accordingly. Statistical analysis was done using the Statistical Package for the Social Sciences version 20 software. Results: Out of 18 patients, at the time of presentation 12 were in moderate grade and six were in severe grade. During subsequent follow up at four weeks and three months, patients showed progressive improvement. 15 patients improved to mild grade while two remained in moderate grade and one in severe grade during three months postoperative assessment. One patient each developed dysphagia, hoarseness and superficial wound infection that were managed conservatively. Conclusion: Anterior cervical discectomy and fusion is one of the effective and safe treatments for single-level degenerative cervical disc disease associated with cervical spondylotic myelopathy with minimal complications.

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