Anterior Cervical Discectomy and Fusion with Polyetheretherketone Cage or Anterior Cervical Plate: A Comparative Evaluation of Short-term Outcomes

Introduction: Anterior cervical discectomy and fusion (ACDF) is a widely used procedure for treating cervical spondylotic myelopathy and radiculopathy. While anterior cervical plating (ACP) is the traditional method to ensure stability and fusion, it may be associated with increased dysphagia, adjacent segment degeneration, and hardware complications. Stand-alone polyetheretherketone (PEEK) cages offer a potential alternative with reduced operative morbidity. However, comparative evidence regarding their short-term clinical and radiological outcomes remains limited. The objective of this study was to compare the short-term clinical and radiological outcomes of ACDF performed using stand-alone PEEK cages versus conventional ACP. Materials and Methods: Current prospective comparative study encompassed 29 patients with cervical radiculopathy or radiculomyelopathy at C3-C7 levels. Group A (n = 14) underwent ACDF with standalone PEEK cage, while Group B (n = 15) underwent conventional ACDF with ACP. Clinical outcomes were determined by employing Visual Analog Scale (VAS) scores, neck pain disability index (NPDI), blood loss, operation time, Odom's criteria, and post-operative dysphagia. Radiological outcomes included fusion rates, cervical Cobb's lordosis, and cage subsidence, assessed at 1, 3, and 6 months post-surgery. Results: Both groups exhibited significant post-surgical improvements in NPDI and VAS scores (P < 0.05), with no notable intergroup differences (P > 0.05). Group A exhibited shorter operation times and less blood loss (P < 0.05). Dysphagia, fusion rates, and surgical outcomes were similar between the groups (P > 0.05). However, Group A exhibited relatively greater cage subsidence, cervical lordosis, loss of disc height, as well as fused segment angle (P < 0.05). Conclusion: ACDF with stand-alone PEEK cages demonstrated clinical outcomes comparable to ACDF with ACP fixation but showed higher rates of post-operative complications, including loss of cervical lordosis and cage subsidence.