ஜர்னல் ஆஃப் ஸ்பைன்

New Approach to Filling a Corpectomy Defect by Stacking Multiple Peek Cages around a Fibula Strut Graft: A Technical Note

Abstract

Kingsley R. Chin, Fabio J.R. Pencle, Jason A Seale, Rishabh G. Jethanandani, Elijah A. Hothem and Vanessa Cumming

Study background: Fibula strut grafts alone during anterior cervical corpectomies have some inherent vulnerability. In contrast PEEK (Polyetheretherketone) cages are more stable but need separate graft material for interbody fusion. The opportunity therefore exists to combine the positive attributes of a fibula strut graft and a PEEK interbody cage for corpectomy. The authors aim to illustrate the use of stacking multiple PEEK cages around a fibula strut graft for cervical corpectomy.

Methods: We present two illustrative cases of the technique of stacking three PEEK cages around a fibula strut graft (group 1). Cases were compared to cohort of 15 patients (group 2) with 3 level anterior cervical discectomy and fusion (ACDF).

Results: Average age and BMI for group 1 was 52 years and 36.9 kg/m2 compared to group 2 average age 59 years and BMI 25 kg/m2, p=0.53 and 0.21 respectively. Mean preop VAS neck score in group 1 of 8.5 compared to group 2 of 6.5, p=0.08. Preop NDI in group 1 of 52 compared to group 2 of 43.4, p=0.355. There was no statistical difference in post op outcomes at 6, 12 and 24 months, p>0.05. There was no evidence of construct failure, subsidence, or focal kyphosis in either group which was demonstrated on CT radiograph.

Conclusion: We have illustrated technique of combining the strength of a fibula strut graft for achieving fusion and PEEK cages for stability and favourable modulus of elasticity of that the vertebrae. The assessment of outcome scores demonstrated similar efficacy of treatment. There were no reported major complications in either group. Further application of this approach is the next steps to establish this technique’s efficacy.