Article Text

  1. M. Lalezarian,
  2. A. N. Shamie,
  3. L. Holly,
  4. L. Khoo,
  5. J. Wang
  1. Department of Orthopaedic Surgery and Neurosurgery, David Geffen School of Medicine, UCLA, Los Angeles, CA


Background and Objectives Lumbar interbody spinal fusion is depended upon as a last resort in patients with chronic lower back pain due to degenerative changes and instability of the spine. The surgical treatment involves the union of two adjacent vertebral bodies with the use of an intervertebral cage, such that a bony connection is formed postoperatively. Bioengineers have recently designed a new radiolucent cage made of PEEK material (polyethylethyleneketone) for use in spinal fusion. Its durability under mechanical stress, strength in compression, and inert nature make it an excellent graft substitute. Furthermore, its radiolucency allows straightforward assessment of the progress of fusion on imaging. The aim of this study is to compare the effectiveness of PEEK material versus Allograft material in lumbar interbody fusion.

Methods After a retrospective chart review of approximately 60 patients at the UCLA-Santa Monica Spine Center, the following criteria were compared: fusion rates based on x-ray evaluation, pain relief based on Odom's Criteria, estimated blood loss, duration of hospital stay, and operative time. All operations were performed at the UCLA Spine Center.

Results Average length of postoperative hospital stay was 4.13 days for Allograft patients and 3.57 days for PEEK patients (p = .112). Average operative time was 5.12 hours for Allograft patients and 34.31 hours for PEEK patients (p = .044). Fusion rate was 100% for Allograft patients and 95.92% for PEEK patients (p = .159). Average estimated blood loss was 223.89 cc for Allograft patients and 285.10 cc for PEEK patients (p = .065). 37.5% and 55% of Allograft and PEEK patients experienced excellent pain relief according to Odom's criteria, respectively.

Conclusion PEEK cages appear to be promising, allowing for high rates of interbody fusion and gratifying clinical results. Future research efforts should be focused towards larger randomized controlled trials.

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