Compared to titanium cage, polyethyletherketone (PEEK) cage with pedicle screw fixation has been increasingly used in transforaminal lumbar interbody fusion (TLIF). However, there is insufficient evidence supporting the superiority of PEEK cages over titanium cages as optimal TLIF spacers. The aim of this study was to compare the clinical and radiographic outcomes of patients at a 1-year follow-up after undergoing instrumented TLIF in which either a PEEK cage or a titanium cage was implanted for spacer [1, 2, 4]
Materials and Methods: We retrospectively analyzed prospectively collected 25 patients who underwent single-level TLIF in which the first 12 patients received a titanium cage and the 13 patients received a PEEK cage. Patient functional outcomes and radiographic imaging, fusion rates, subsidence failures were studied in follow up.
Results: Improvement of clinical outcomes was comparable between the two groups. Based on the criteria using repeated x rays with dynamic views, 83.33% in the Titanium group and 69.23% in the PEEK group showed fusion at 6 months. At 12 months, fusion rate in the Titanium group was increased to 100 %, while PEEK group showed 84 % of fusion rate. In the PEEK group, vertebral osteolysis was comparatively higher and 2 cases showed non-union.
Conclusion: Although there is no significant difference between peek cage and kidney cage for interbody fusion and clinical outcome but there is more chances of subsidence in kidney (titanium) group and hence segmental kyphosis than other group. Vertebral osteolysis in few cases of peek group might not provide a satisfactory fusion.