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Pseudarthrosis following single-level ACDF is five times more likely when a PEEK interbody device is used

By Admin | November 21, 2018

In spine surgery, "arthrodesis" is the term used to describe fusion of adjacent vertebrae following removal of an intervertebral disc. Arthrodesis is achieved by placing a bone graft or bone graft substitute between the vertebrae to bridge the empty space so that new bone can grow between. "Pseudarthrosis" is the term used to describe failure of this expected new bone growth.

Researchers at the Department of Neurological Surgery, Oregon Health & Science University, found pseudarthrosis to be five times more likely after a polyetheretherketone (PEEK) interbody spacer device had been used to bridge the gap between vertebrae during cervical spine surgery than after a structural (bone) allograft had been used. The researchers' findings appear in a new article published today in the Journal of Neurosurgery: Spine: "Fivefold higher rate of pseudarthrosis with polyetheretherketone interbody device than with structural allograft used for 1-level anterior cervical discectomy and fusion," written by Katie L. Krause, MD, PhD, and colleagues


Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure performed in patients experiencing pain or weakness due to a herniated or deteriorated intervertebral disc in the neck. During the operation, the surgeon approaches the cervical spine from the front of the body, thus avoiding the spinal cord, spinal nerves, and thick neck muscles. After reaching the spine, the surgeon removes the damaged disc, which lies between two adjacent vertebrae, and replaces it with a bone graft or an artificial graft packed with bone fragments or bone-inducing proteins that serves to "fuse" the two vertebrae together and stabilize the spine. ACDF can be performed at a single level (replacing one disc between two adjacent vertebrae with a graft) or at multiple levels (replacing multiple discs with grafts).

In this paper, the authors focus on two graft materials commonly used to bridge the gap between two vertebrae after disc removal: structural allograft and polyetheretherketone (PEEK). Structural allograft is a sterilized piece of bone obtained from a cadaver. It has no active bone cells or bone-inducing proteins itself, but acts as a natural scaffold over which bone can regrow. PEEK is a strong, biocompatible plastic. Although itself bioinert, this plastic scaffold is packed with bone shavings or proteins at the time of surgery to induce bone growth.

To learn more on this study, please read Pseudarthrosis following single-level ACDF is five times more likely when a PEEK interbody device is used by EurekAlert. 

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