Although fusion was observed in all patients of the two groups at the final follow-up, the Titanium group demonstrated significantly inferior clinical outcomes compared to the PEEK group.
Shanghai, China (PRWEB) June 24, 2013
A seven year clinical study has concluded that a cage made of the high performance PEEK polymer is superior to a Titanium cage in maintenance of intervertebral height and cervical lordosis in surgical treatment of multilevel cervical spondylotic myelopathy (CSM). According to the study, published in the European Spine Journal this results in better clinical outcomes in long-term follow-up. The randomized study with a total of 80 patients includes an average follow-up period of around 7 years.
In the treatment of CSM anterior cervical discectomy and fusion (ACDF) with titanium- or polyetheretherketone (PEEK)-cage reconstruction is typically used. Titanium implants offer structural properties that are likely to provide a good immediate stability and osseointegration, whilst PEEK cages have a modulus of elasticity closely resembling that of cortical bone, which might lead to advantages in load sharing and stress distribution. Until now a direct comparison of titanium and PEEK cages in the treatment of cervical disc degeneration disease is rarely found in literature.
Dr Chen Y and colleagues from the Department of Spine Surgery, Changzhen Hospital, Shanghai, designed the study to compare outcomes of titanium and PEEK cages. A total of 80 patients with 3-level CSM were randomized in a 1:1 ratio into two groups between November 2002 and December 2004. The overall follow-up period of the patients ranged from 86 to 116 months (average 99.7 months).
The clinical outcomes including JOA (Japanese Orthopedic Association) score, NDI (Neck Disability Index) score demonstrate that patients benefit from cages made of implantable PEEK polymer. “Although fusion was observed in all patients of two groups at the final follow-up, the Titanium group demonstrated significantly inferior clinical outcomes compared to the PEEK group. More loss of the Cobb angles, measurement of spine curvature, and the intervertebral height was observed in the titanium group, resulting in the radiological parameters in the titanium group becoming inferior to the PEEK group at the final follow-up. Cage subsidence rates were 34.5 % in the titanium and 5.4 % in the PEEK group. The higher modulus of the titanium material properties, is the likely cause of this.” The research team comments on the results of the study.
About Changzheng Hospital
Established in 1900, Shanghai Changzheng hospital is a comprehensive Three A hospital in Shanghai, which combines medical, educational and scientific research functions.
The number of spinal procedures carried out at the hospital is increasingly growing, the cervical procedures broke through 25,000 cases, among which, the highly difficult occipital cervical procedures exceed 3000 cases. The hospital builds up its specialities in the treatment of cervical spondylopathy, lumbar degenerative disc disease, upper cervical disease, spinal trauma, spinal minimally invasive surgery, etc., this positions the Shanghai Changzheng hospital as the leading hospital in this field.
Shanghai Changzheng hospital is strong in both expertise and hardware facilities, it has been awarded as the advanced hospital in China on a number of occasions and has cultivated a vast number of excellent medical experts for the nation.