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Schröder J, Kampulz T, Bajaj SK, Hellwig AG, Winking M. PEEK Cages versus Titanium-Coated PEEK Cages in Single-Level Anterior Cervical Fusion: A Randomized Controlled Study. J Neurol Surg A Cent Eur Neurosurg 2024; 85:262-268. [PMID: 37506743 DOI: 10.1055/s-0043-1770694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND The implantation of a spacer is a common practice after anterior diskectomy in cervical spine. Polyether ether ketone (PEEK) cages have replaced titanium implants due to their better radiologic visibility and appearance in postoperative magnetic resonance imaging (MRI) scans. However, PEEK showed apparently higher nonunion rates than titanium cages. The aim of the study was to evaluate the fusion behavior of plain PEEK cages in comparison to titanium-coated PEEK (TiPEEK) cages. METHOD We randomized 104 patients with single-level cervical radiculopathy or mild myelopathy. They were divided into two groups of 52 patients each, receiving either a PEEK cage or the titanium-coated variant of the same cage type. The 1- and 2-year follow-ups were completed by 43 patients in the PEEK group and by 50 patients in the TiPEEK group. Fusion was determined by plain X-ray and lateral functional X-ray. RESULTS Two years after surgery, a complete fusion was observed in 37 patients of the PEEK group (86%). Six cases were considered as nonunions. In the TiPEEK group, we found 41 fusions (82%) and 9 nonunions at this time. The difference was not considered significant (p = 0.59). The clinical evaluation of the two groups showed no difference in the neurologic examination as well in the pain scores over the time period. CONCLUSIONS Despite some assumptions about an advantage of TiPEEK over PEEK cages for fusion in cervical spine surgery, this prospective randomized controlled study did not find an accelerated or improved fusion using TiPEEK for anterior cervical diskectomy.
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Affiliation(s)
| | - Thomas Kampulz
- ZW-O Zentrum für - Wirbelsäulenchirurgie, Osnabrück, Germany
| | | | | | - Michael Winking
- ZW-O Zentrum für - Wirbelsäulenchirurgie, Osnabrück, Germany
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2
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Jalilvand E, Abollfathi N, Khajehzhadeh M, Hassani-Gangaraj M. Optimization of cervical cage and analysis of its base material: A finite element study. Proc Inst Mech Eng H 2022; 236:1613-1625. [DOI: 10.1177/09544119221128467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Nowadays, cervical disorders are common due to human lifestyles. Accordingly, the cage design should be optimized as an essential issue. For an optimal design, an objective function is utilized to calculate the proper geometrical parameters. Additionally, the base material of the cage plays a key role in its functionality and final cost. Novel materials are currently introduced with more compatibility with the bone in terms of mechanical and chemical properties. In this study, a cervical cage was modeled based on PEEK material with three types of tooth designs on its surface. The cervical cage is assumed to be implanted between C6 and C7 vertebrae. The geometric parameters of the cage were optimized to minimize the mass by determining allowable stress and subsidence. The effect of complete cortical removal was investigated as a surgical mistake. Finally, a new composition of PEEK/titanium was introduced as the base material of the cage. Ansys 18.2 was used for FEA. The cage with a straight tooth was chosen due to its lower stress and subsidence compared with other designs. Furthermore, the optimized structures of all three tooth designs were determined. The mass and volume of the optimal cages were reduced by 41.47% and 41.52% respectively. Besides, complete cortical resection should not be carried out during fusion surgery, since it may lead to higher subsidence. The composition of PEEK/titanium was chosen as an appropriate base material due to its better performance compared with PEEK or titanium alone.
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Affiliation(s)
- Elahe Jalilvand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Nabiolah Abollfathi
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mohsen Khajehzhadeh
- Department of Mechanical Engineering, Amirkabir University of Technology, Tehran, Iran
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Muthiah N, Yolcu YU, Alan N, Agarwal N, Hamilton DK, Ozpinar A. Evolution of polyetheretherketone (PEEK) and titanium interbody devices for spinal procedures: a comprehensive review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:2547-2556. [PMID: 35689111 DOI: 10.1007/s00586-022-07272-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/22/2022] [Accepted: 05/18/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Interbody fusion is commonly utilized for arthrodesis and stability among patients undergoing spine surgery. Over the last few decades, interbody device materials, such as titanium and polyetheretherketone (PEEK), have been replacing traditional autografts and allografts for interbody fusion. As such, with the exponential growth of bioengineering, a large variety cage surface technologies exist. Different combinations of cage component materials and surface modifications have been created to optimize interbody constructs for surgical use. This review aims to provide a comprehensive overview of common surface technologies, their performance in the clinical setting, and recent modifications and material combinations. MATERIALS AND METHODS We performed a comprehensive review of the literature on titanium and PEEK as medical devices between 1964 and 2021. We searched five major databases, resulting in 4974 records. Articles were screened for inclusion manually by two independent reviewers, resulting in 237 articles included for review. CONCLUSION Interbody devices have rapidly evolved over the last few decades. Biomaterial and biomechanical modifications have allowed for continued design optimization. While titanium has a high osseointegrative capacity, it also has a high elastic modulus and is radio-opaque. PEEK, on the other hand, has a lower elastic modulus and is radiolucent, though PEEK has poor osseointegrative capacity. Surface modifications, material development advancements, and hybrid material devices have been utilized in search of an optimal spinal implant which maximizes the advantages and minimizes the disadvantages of each interbody material.
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Affiliation(s)
- Nallammai Muthiah
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA, 15213, USA
| | | | - Nima Alan
- Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA, 15213, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - David Kojo Hamilton
- Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA, 15213, USA
| | - Alp Ozpinar
- Department of Neurosurgery, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA, 15213, USA.
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PEEK versus titanium-coated PEEK cervical cages: fusion rate. Acta Neurochir (Wien) 2022; 164:1501-1507. [PMID: 35471708 DOI: 10.1007/s00701-022-05217-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/17/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Anterior cervical discectomy and fusion (ACDF) is one of the most commonly performed procedures for degenerative cervical disease. The evaluation of fusion status is still not fully standardized, and a variety of measurement methods are used. This study presents our own evaluation of fusion by comparing two types of implants. METHODS A total of 170 disc spaces were operated on in 104 patients using PEEK (polyetheretherketone) cages and titanium-coated (TC) PEEK cages. Patients were assigned to a specific implant using a randomisation table. Fusion status was evaluated based on functional radiographs and CT scans obtained at 12 months post-surgery. Multivariate mixed-effects logistic regression models were performed to assess the association of type of implant with different fusion rates. RESULTS At 12 months post-surgery, CT scans were performed in 86 patients (a total of 144 disc spaces) and conventional radiographs were obtained in 102 (a total of 166 disc spaces). Complete fusion was demonstrated in 101 cases (71.1%), partial fusion in 43 cases (29.9%). There were no cases of absence of fusion. A total of 85 PEEK cages (59%) and 59 TC-PEEK cages (41%) were implanted. For PEEK cages, complete fusion was seen in 75 (88.2%) disc spaces, compared to 26 (44.1%) achieved with TC-PEEK cages. A significantly higher proportion of complete fusions (B = 15.58; P < 0.0001) after 12 months was observed with PEEK implants compared to TC-PEEK implants. CONCLUSION Complete fusion was noted at 12 months post-surgery significantly more frequently with PEEK implants compared to TC-PEEK implants.
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Immunomodulatory Properties and Osteogenic Activity of Polyetheretherketone Coated with Titanate Nanonetwork Structures. Int J Mol Sci 2022; 23:ijms23020612. [PMID: 35054795 PMCID: PMC8775651 DOI: 10.3390/ijms23020612] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 12/23/2022] Open
Abstract
Polyetheretherketone (PEEK) is a potential substitute for conventional metallic biomedical implants owing to its superior mechanical and chemical properties, as well as biocompatibility. However, its inherent bio-inertness and poor osseointegration limit its use in clinical applications. Herein, thin titanium films were deposited on the PEEK substrate by plasma sputtering, and porous nanonetwork structures were incorporated on the PEEK surface by alkali treatment (PEEK-TNS). Changes in the physical and chemical characteristics of the PEEK surface were analyzed to establish the interactions with cell behaviors. The osteoimmunomodulatory properties were evaluated using macrophage cells and osteoblast lineage cells. The functionalized nanostructured surface of PEEK-TNS effectively promoted initial cell adhesion and proliferation, suppressed inflammatory responses, and induced macrophages to anti-inflammatory M2 polarization. Compared with PEEK, PEEK-TNS provided a more beneficial osteoimmune environment, including increased levels of osteogenic, angiogenic, and fibrogenic gene expression, and balanced osteoclast activities. Furthermore, the crosstalk between macrophages and osteoblast cells showed that PEEK-TNS could provide favorable osteoimmunodulatory environment for bone regeneration. PEEK-TNS exhibited high osteogenic activity, as indicated by alkaline phosphatase activity, osteogenic factor production, and the osteogenesis/osteoclastogenesis-related gene expression of osteoblasts. The study establishes that the fabrication of titanate nanonetwork structures on PEEK surfaces could extract an adequate immune response and favorable osteogenesis for functional bone regeneration. Furthermore, it indicates the potential of PEEK-TNS in implant applications.
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Mobbs RJ, Amin T, Ho D, McEvoy A, Lovric V, Walsh WR. Integral fixation titanium/polyetheretherketone cages for cervical arthrodesis: Two-year clinical outcomes and fusion rates using β-tricalcium phosphate or supercritical carbon dioxide treated allograft. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2021; 12:368-375. [PMID: 35068818 PMCID: PMC8740808 DOI: 10.4103/jcvjs.jcvjs_129_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 11/06/2021] [Indexed: 11/13/2022] Open
Abstract
Context: Despite increasing promising reports regarding composite titanium (Ti)/PolyEtherEtherKetone (PEEK) cages, further longer-term, quality research is required. Synthetic bone graft substitutes are another rapidly developing area of spinal surgical research. Aims: The purpose of this study is to evaluate the outcomes of an integral fixation composite Ti/PEEK cage for anterior cervical discectomy and fusion (ACDF) and compare a synthetic bone graft substitute (β-tricalcium phosphate; [βTCP]) with allograft processed using supercritical fluid technology. Methods and Design: Data from 195 consecutive patients were prospectively collected from a single centre. Indications were largely degenerative. Allograft and βTCP were used in a 3:1 randomization protocol. Patients were followed up for a minimum of 6 months and up to 48 months. Clinical outcomes included visual analogue scale and neck oswestry disability index. Radiographic outcomes included fusion rates, subsidence rates and implant complications. Results: Graft sub-cohorts were largely comparable and included 133 and 52 patients in the allograft and βTCP sub-cohorts, respectively. Clinical outcomes overall significantly improved (P < 0.001), with no significant inter-cohort differences. There were no implant-related complications. Overall fusion rate was 94.1% (175/186). The allograft cohort produced a significantly greater fusion rate of 97.7% (126/129) compared to 77.6% (38/49) for the βTCP cohort (P = 0.001). Conclusions: This study demonstrates the viability of an integral fixation composite Ti/PEEK ACDF device in effectively and safely improving patient outcomes and achieving fusion. Allograft is more effective in achieving fusion compared to βTCP, though both were similarly efficacious in improving clinical outcomes.
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Affiliation(s)
- Ralph J Mobbs
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, UNSW Sydney, Australia.,Prince of Wales Clinical School, UNSW Sydney, Australia.,Surgical and Orthopaedic Research Labs (SORL), Prince of Wales Clinical School, UNSW Sydney, Sydney, Australia
| | - Tajrian Amin
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, UNSW Sydney, Australia.,Prince of Wales Clinical School, UNSW Sydney, Australia
| | - Daniel Ho
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, UNSW Sydney, Australia.,Prince of Wales Clinical School, UNSW Sydney, Australia
| | - Aidan McEvoy
- Matrix Medical Innovations, Randwick, Sydney, Australia
| | - Vedran Lovric
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Surgical and Orthopaedic Research Labs (SORL), Prince of Wales Clinical School, UNSW Sydney, Sydney, Australia
| | - William R Walsh
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Surgical and Orthopaedic Research Labs (SORL), Prince of Wales Clinical School, UNSW Sydney, Sydney, Australia
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Jain A, Marrache M, Harris A, Puvanesarajah V, Neuman BJ, Buser Z, Wang JC, Yoon ST, Meisel HJ. Structural Allograft Versus PEEK Implants in Anterior Cervical Discectomy and Fusion: A Systematic Review. Global Spine J 2020; 10:775-783. [PMID: 32707023 PMCID: PMC7383799 DOI: 10.1177/2192568219883256] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
STUDY DESIGN Systematic literature review. OBJECTIVE Our primary objective was to compare reported fusion rates after anterior cervical discectomy and fusion (ACDF) using structural allograft versus polyetheretherketone (PEEK) interbody devices in patients with cervical spine degeneration. Our secondary objectives were to compare differences in rates of subsidence and reoperation and in patient-reported outcomes between the 2 groups. METHODS Through a systematic review of the English-language literature using various databases, we identified 4702 articles. After we applied inclusion and exclusion criteria, 14 articles (7 randomized controlled trials, 4 prospective studies, and 3 retrospective studies) reporting fusion rates of structural allograft or PEEK interbody devices were eligible for our analysis. No randomized controlled trials compared outcomes of structural allograft versus PEEK interbody devices. Extracted data included authors, study years, study designs, sample sizes, patient ages, duration of follow-up, types of interbody devices used, fusion rates, definition of fusion, reoperation rates, subsidence rates, and patient-reported outcomes. RESULTS Fusion rates were 82% to 100% for allograft and 88% to 98% for PEEK interbody devices. The reported data were insufficient to perform meta-analysis. Structural allograft had the highest reported rate of reoperation (14%), and PEEK interbody devices had the highest reported subsidence rate (18%). Patient-reported outcomes improved in both groups. There was insufficient high-quality evidence to compare the associations of various PEEK modifications with fusion rates. CONCLUSION Fusion rates were similar between structural allograft and PEEK interbody devices when used for ACDF for cervical spine degeneration. Currently, there is insufficient high-quality evidence to assess associations of PEEK modifications with fusion rates. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Amit Jain
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Amit Jain, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 North Caroline Street, JHOC 5223, Baltimore, MD 21287, USA.
| | - Majd Marrache
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Harris
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Varun Puvanesarajah
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brian J. Neuman
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zorica Buser
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jeffrey C. Wang
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - S. Tim Yoon
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - Hans Jörg Meisel
- Department of Neurosurgery, BG-Clinic Bergmannstrost, Halle, Germany
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Choy WJ, Parr WCH, Phan K, Walsh WR, Mobbs RJ. 3-dimensional printing for anterior cervical surgery: a review. JOURNAL OF SPINE SURGERY (HONG KONG) 2018; 4:757-769. [PMID: 30714008 PMCID: PMC6330582 DOI: 10.21037/jss.2018.12.01] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 01/10/2023]
Abstract
Age-related degenerative changes and non-spondylotic pathologies of the cervical spine such as trauma and tumor can lead to compression of neurological structures and result in substantial alteration of the structural anatomy. The end-goal of surgical intervention is to decompress the neural structures which can be achieved via an anterior or a posterior approach, and stabilization of segments to restore stability and alignment. Three-dimensional printing (3DP or Additive Manufacturing) has been applied to the field of medicine, in particular orthopedics and neurosurgery. Coupled with advances of medical imaging such as computed tomography (CT) scans and magnetic resonance imaging (MRI), accurate 3D models of patient anatomy can be produced, and patient-specific implants (PSIs) for complex anatomical reconstruction have all been applied with positive outcomes. 3D printed implants have been applied in particular to the cervical spine predominantly due to the complex and relatively small osteological anatomy and the proximity of important neurovascular structures to the surgical sites. The purpose of this review is to evaluate the current application of 3DP for cervical spinal implants. This includes a review on the available literature on 3D printed PSIs and current available 3D printed "off-the-shelf" (OTS) implants (3D-OTS). Suitable materials for 3DP of spinal implants and the future prospect of cervical implants will be discussed. The review will be concluded with a suggested guide for carrying future studies to evaluate the efficacy and safety of 3DP for cervical spinal implants.
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Affiliation(s)
- Wen Jie Choy
- University of New South Wales Sydney, Sydney, Australia
- NeuroSpine Surgery Research Group, Sydney, Australia
- Surgical Orthopedics Research Lab, Prince of Wales Randwick, Sydney, Australia
| | - William C. H. Parr
- University of New South Wales Sydney, Sydney, Australia
- NeuroSpine Surgery Research Group, Sydney, Australia
- Surgical Orthopedics Research Lab, Prince of Wales Randwick, Sydney, Australia
- 3D Morphic Sydney, Sydney, Australia
| | - Kevin Phan
- University of New South Wales Sydney, Sydney, Australia
- NeuroSpine Surgery Research Group, Sydney, Australia
- Surgical Orthopedics Research Lab, Prince of Wales Randwick, Sydney, Australia
- Department of Neurosurgery, Prince of Wales Private, Sydney, Australia
| | - William R. Walsh
- University of New South Wales Sydney, Sydney, Australia
- NeuroSpine Surgery Research Group, Sydney, Australia
- Surgical Orthopedics Research Lab, Prince of Wales Randwick, Sydney, Australia
| | - Ralph J. Mobbs
- University of New South Wales Sydney, Sydney, Australia
- NeuroSpine Surgery Research Group, Sydney, Australia
- Surgical Orthopedics Research Lab, Prince of Wales Randwick, Sydney, Australia
- Department of Neurosurgery, Prince of Wales Private, Sydney, Australia
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Junaid M, Rashid MU, Bukhari SS, Ahmed M. Radiological and clinical outcomes in patients undergoing anterior cervical discectomy and fusion: Comparing titanium and PEEK (polyetheretherketone) cages. Pak J Med Sci 2018; 34:1412-1417. [PMID: 30559795 PMCID: PMC6290230 DOI: 10.12669/pjms.346.15833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objectives: To study clinical and radiological outcomes in patients who had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages for cervical disc prolapse. Methods: This is a retrospective/non-randomized study which was conducted at the Combined Military Hospital Peshawar. Study interval was four years from 1st October, 2010 to 31st September, 2014. Total number of included patients were 149. All of the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages. All of the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse. Results: Most of the patients had stenosis at the C5 / C6 (PEEK cage group 63% and titanium cage group 47.6%) and C6 / C7 (PEEK cage group 15.38% and titanium cage group 19.04%) cervical level. Bi-level involvement was also seen. In the patients who complained of brachialgia, total resolution of symptoms was seen after the operation. Three (2.01%) of the patients in titanium cage group, who presented with axial neck pain, continued to complain of pain after the operation. Four (2.6%) of the patients in PEEK (polyetheretherketone) cage group and 2 (1.3%) in titanium cage group complained of pain at the donor site (iliac crest). Fusion rate was 100% with both titanium and PEEK (polyetheretherketone) cages at one year. Conclusion: Results with titanium and PEEK (polyetheretherketone) cages are excellent. There was no significant difference in clinical and radiological outcome between two groups of patients (p > 0.05). Fusion rate was 100% at one year with both cages.
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Affiliation(s)
- Muhammad Junaid
- Dr. Muhammad Junaid, FCPS. Associate Professor Head of Neurosurgery, PNS Shifa, Karachi, Pakistan
| | - Mamoon Ur Rashid
- Dr. Mamoon Ur Rashid, MBBS. Department of Internal Medicine, Orlando Hospital, Orlando, FL, USA
| | - Syed Sarmad Bukhari
- Dr. Syed Sarmad Bukhari, MBBS. Resident Neurosurgery, Aga Khan University Hospital, Karachi. Pakistan
| | - Mamoon Ahmed
- Dr. Mamoon Ahmed, MBBS. House Officer, Jinnah Hospital, Lahore, Pakistan
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Moussa A, Tanzer M, Pasini D. Cervical fusion cage computationally optimized with porous architected Titanium for minimized subsidence. J Mech Behav Biomed Mater 2018; 85:134-151. [DOI: 10.1016/j.jmbbm.2018.05.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/16/2018] [Accepted: 05/29/2018] [Indexed: 11/25/2022]
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Kassick AJ, Yerneni SS, Gottlieb E, Cartieri F, Peng Y, Mao G, Kharlamov A, Miller MC, Xu C, Oh M, Kowalewski T, Cheng B, Campbell PG, Averick S. Osteoconductive Enhancement of Polyether Ether Ketone: A Mild Covalent Surface Modification Approach. ACS APPLIED BIO MATERIALS 2018; 1:1047-1055. [DOI: 10.1021/acsabm.8b00274] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andrew J. Kassick
- Neuroscience Disruptive Research Lab, Allegheny Health Network Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Saigopalakrishna S. Yerneni
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15217, United States
| | - Eric Gottlieb
- Department of Chemistry, Carnegie Mellon University, Pittsburgh, Pennsylvania 15217, United States
| | - Francis Cartieri
- Department of Surgery Allegheny Health Network, West Penn Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Yushuan Peng
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15217, United States
| | - Gordon Mao
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Alexander Kharlamov
- Department of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Mark C. Miller
- Department of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
- Departments of Mechanical Engineering and Materials Science & Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Chen Xu
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Michael Oh
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Tomasz Kowalewski
- Department of Chemistry, Carnegie Mellon University, Pittsburgh, Pennsylvania 15217, United States
| | - Boyle Cheng
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Phil G. Campbell
- Department of Biomedical Engineering and Engineering Research Accelerator, Carnegie Mellon University, Pittsburgh, Pennsylvania 15217, United States
| | - Saadyah Averick
- Neuroscience Disruptive Research Lab, Allegheny Health Network Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
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