Distractable titanium cages versus PEEK cages versus iliac crest bone grafts for the replacement of cervical vertebrae

Abstract

Objective: To analyse the advantages and disadvantages of distractable titanium cages, polyether-etherketone cages, and iliac crest bone graft for the replacement of cervical vertebral bodies (VBR). Methods: The clinical and radiological results of 32 patients who underwent cervical corpectomy for the decompression of the spinal canal were retrospectively analysed and discussed. Results: For the vertebral body replacement the authors used distractable titanium cages (n = 6), PEEK cages (n = 19), and iliac crest bone graft (n = 7). The neurological outcomes according to postoperative JOA scores did not show significant differences between the three groups. PEEK cages showed a high rate of secondary subsidence (32%). Discussion: Despite the risk of donor site morbidity the authors recommend iliac crest bone graft as primary choice for VBR because of its excellent fusion rate and its cost effectiveness. For revision cases we recommend titanium cages.

Key words::

• Cervical spine surgery
• vertebral body replacement
• titanium
• polyether-etherketone
• iliac crest bone graft
• technology
• surgical education

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.