Stand-alone cervical polyetheretherketone (PEEK) cage (cervios) for single to two-level degenerative disc disease.

Objective: To study clinical and radiographic outcome of patients who underwent the Cervios cage-assisted anterior cervical discectomy and fusion (ACDF) without plate fixation in single to two-level degenerative disc disease (DDD).

Methods: Sixty-seven patients suffering from cervical DDD with various symptoms such as radiculopathy, myelopathy, or both were retrospectively evaluated. The cervical DDD was confirmed by plain radiographs and MR imaging The patients underwent radiographic evaluation to assess cervical lordosis, intervertebral height (IH), fusion, and subsidence. Clinical assessment was graded using a visual analog scale (VAS), Modified JOA (Japanese Orthopedic Association) score, Neck Disability Index (NDI).

Results: There were ninety two ACFD in two levels of operation. Single-level ACDF was performed in 42 patients and two-level in 25. The outcomes revealed the significant improvement of clinical outcome and restoration of cervical lordosis. The fusion rate was 97%, whereas subsidence occurred 7.61% but produced no symptom. There was no anterior or posterior migration of the cage. Complications included transient dysphagia in three patients and superficial wound infection in two patients.

Conclusions: The present study indicates that one- to two-level stand alone Cervios cage-assisted interbody fusion without plate fixation provides improvement of clinical outcomes, restoration of lordosis and high fusion rate. However subsidence occurred in 7.61% but did not cause clinical symptoms and the patients had to use the cervical collar postoperatively.