An April 9, 2013 article in the European Spine Journal’s online edition has concluded that implants made from polyetheretherketone (PEEK) are superior to those made from titanium in maintaining intervertebral height and cervical lordosis during treatment of multilevel cervical spondylotic myelopathy (CSM).
Initiated in November 2002, the China centric prospective, randomized control study (which included a minimum of 7 years of follow up) conclusively showed that PEEK cages resulted in better clinical outcomes. According to the research, although fusion was observed in all patients, the titanium group was found to be more than 6x more likely to experience cage subsidence than its PEEK counterpart, with a rate of 34.5% versus 5.4% for the PEEK group participants. The study also noted that PEEK cages have a modulus of elasticity closely resembling that of cortical bone, which might lead to advantages in load sharing and stress distribution, when compared to the higher modulus of titanium.
The JOA (Japanese Orthopedic Association) score and the NDI (Neck Disability Index) were two of the tests used in the evaluation. Both tests demonstrated that cages made from PEEK benefit patients.
In all, 80 patients were followed – recruited for enrollment between November 2002 and December 2004. Criteria for inclusion included symptoms of cervical myelopathy and/or radiculopathy, intervertebral disc degeneration and herniation with posterior vertebral body osteophyte formation, cervical pathology in three consecutive levels and no response to a minimum of 6 weeks of conservative treatment. The overall follow-up period of the participants ranged from 86 to 116 months, with an average of 99.7 months.
For more information, go to: http://www.ncbi.nlm.nih.gov/pubmed/23568254