Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Radiologic Assessment of Subsidence in Stand-Alone Cervical Polyetheretherketone (PEEK) Cage

  • Ha, Sung-Kon (Department of Neurosurgery, Korea University Medical Center Ansan Hospital) ;
  • Park, Jung-Yul (Department of Neurosurgery, Korea University Medical Center Ansan Hospital) ;
  • Kim, Se-Hoon (Department of Neurosurgery, Korea University Medical Center Ansan Hospital) ;
  • Lim, Dong-Jun (Department of Neurosurgery, Korea University Medical Center Ansan Hospital) ;
  • Kim, Sang-Dae (Department of Neurosurgery, Korea University Medical Center Ansan Hospital) ;
  • Lee, Sang-Kook (Department of Neurosurgery, Korea University Medical Center Ansan Hospital)
  • Published : 2008.12.31
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Abstract

Objective : Aim of study was to find a proper method for assessing subsidence using a radiologic measurement following anterior cervical discectomy and fusion (ACDF) with stand-alone polyetheretherketone (PEEK), $Solis^{TM}$ cage. Methods : Forty-two patients who underwent ACDF with $Solis^{TM}$ cage were selected. With a minimum follow-up of 6 months, the retrospective investigation was conducted for 37 levels in 32 patients. Mean follow-up period was 18.9 months. Total intervertebral height (TIH) of two fused vertebral bodies was measured on digital radiographs with built-in software. Degree of subsidence (${\Delta}TIH$) was reflected by the difference between the immediate postoperative and follow-up TIH. Change of postoperative disc space height (CT-MR ${\Delta}TIH$) was reflected by the difference between TIH of the preoperative mid-sagittal 2D CT and that of the preoperative mid-sagittal T1-weighted MRI. Results : Compared to preoperative findings, postoperative disc height was increased in all cases and subsidence was observed only in 3 cases. For comparison of subsidence and non-subsidence group, TIH and CT-MR ${\Delta}TIH$ of each group were analyzed. There was no statistically significant difference in TIH and CT-MR ${\Delta}TIH$ between each group at 4 and 8 weeks, but a difference was observed at the last follow-up TIH (p=0.0497). Conclusion : ACDF with $Solis^{TM}$ cage was associated with relatively good radiologic long-term results. Fusion was achieved in 94.5% and subsidence occurred in 8.1% by the radiologic assessment. Statistical analysis reveals that the subsidence seen later than 8 weeks after surgery and the development of subsidence does not correlate statistically with the change of the postoperative disc space height.

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