One-Year Outcome Comparison of Polyetheretherketone Cage and Disc Prosthesis in Cervical Disc Replacement Surgery

Objective: Anterior cervical microdiscectomy (ACD) is an established surgical method to treat cervical disc disease. Since ACD changes the natural distribution of biomechanical forces, grafts are often used. The most commonly used grafts are a polyetheretherketone (PEEK) cage or a cervical disc prothesis (CDP). This study is a comparison of the early period results of single-level ACD performed using a PEEK cage or a CDP. Materials and Methods: A total of 80 patients with a single-level cervical disc herniation who underwent ACD with PEEK cage (n=40) or CDP (n=40) implantation between 2015-2018 at a single center were retrospectively evaluated. The Cobb angle, T1-slope angle, segmental fusion angle, cervical-tilt angle, and disc height at the operated level were measured using cervical lateral radiographs and magnetic resonance images obtained preoperatively and at 1 day, 1 month, and 12 months postoperative. Neck pain was also evaluated pre- and postoperatively. Results: No statistically significant difference was seen between the groups in the parameters measured at the first and 12th months (p=0.481). In both groups, the preoperative and 12th-month measurements were found to be statistically significant (p=0.001). The development of adjacent segment disease (ASD) was not statistically different between groups. Conclusion: Although a CDP has some advantages in short-term outcomes, there is still insufficient evidence regarding long-term outcomes, particularly regarding the prevention of ASD. CDP implantation offers an earlier return to work and no requirement for an external cervical orthosis, but due to the high cost and some specific complications, such as implant dislocation, heterotopic ossification, and fusion, CPD is still far from a gold-standard treatment option, even for selected cases.