Prospective Comparative Study of Anterior Cervical Discectomy Alone, With Iliac Crest Bone Graft Fusion and PEEK Cage Fusion

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Abstract

  Background & Objective : The preferred Selection of the anterior cervical discectomy alone, with iliac crest bone graft fusion and using the PEEK cage is still in controversial in degenerative disc disease. The aim of this study is comparing them on radiographic and clinical results. Materials & Methods: The all consecutive patients in the three hospitals in Tehran between the 2000 up to the 2003 years were selected and located in ACD, ACDF and PEEK cage groups and at least undergoing 18 months follow up after the surgery, and finally, data were analyzed by using the SPSS program. Results: 31 patients were located in the ACD, 37 in the ACDF, and 35 in the PEEK cage group. The clinical improvement range (Modified PROLO Scale) was 1.53±1.18. The patients' satisfaction mean was 8.23±2.12 according to the G.S.I that in the PEEK cage group was more than other groups. At the end of follow up fusion was achieved in 94.05% of the patients that there was not any significant difference between the groups. But in multilevel involvement, the difference was meaningful and it was more in the groups with fusion rather than the group of ACD. The most complications were related to the ACDF and the least to the PEEK cage group. Height of foramen was decreased in the ACD and ACDF groups, and increased in the PEEK cage group.  Conclusion: Fusion is necessary in multilevel involvement. PEEK cage fusion appropriately increases foramen height better than others and has less complications and similar clinical results, satisfaction rate and easy radiographic follow up. Therefore, utilizing this technique is better and suggested if the patients' selection has been done exactly.

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