• Christopher Brenke, Stephanie Kindling, Johann Scharf, Kirsten Schmieder, and Martin Barth.
• Department of Neurosurgery, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Germany.
• Spine. 2013 May 15;38(11):E635-40.

Study DesignProspective clinical single center series with 50 patients to include, with planned follow-up intervals at 3 and 12 months postoperative.ObjectiveAbsorbable cages were developed with the purpose to enhance fusion rates and to reduce the rate of cage subsidence. The gradual increase of load transfer during cage degradation facilitates new bone formation, which possibly leads to higher arthrodesis rates.Summary Of Background DataAbsorbable cages consisting of a mixture of polylactic and polyglycolic acid (PLLA-PGLA) or poly (L-lactide-co-D, L-lactide) experimentally showed disappointing results with formation of cartilage and fibrous tissue components, which was much less pronounced using composite cages consisting of a polymer and calciumphosphate.MethodsPatients showing degenerative cervical mono- or bi-level pathology were prospectively included. Using anteroposterior and lateral radiographs, segmental height of the treated segments was determined quantitatively. Cage characteristics were described qualitatively. Clinical data such as the Neck Disability Index, pain severity on the visual analogue scale were collected at all time points separately for neck and arm.ResultsA total of 33 patients were included, with a mean age of 51.9 ± 9 years. As cage dislocations occurred in 4 out of 33 patients (12.1%), the study was prematurely discontinued. All patients with cage dislocations were surgically revised. Clinical outcome of the remaining patients showed significant improvement of visual analogue scale neck pain from 6.0 ± 2.5 to 2.8 ± 2.3 (P < 0.005), visual analogue scale arm pain from 5.3 ± 2.7 to 1.6 ± 1.6 (P < 0.005), and Neck Disability Index from 21.2 ± 8.6 to 12.5 ± 9.6 (P < 0.005) after surgery.ConclusionBecause of the high rate of cage dislocations, the use of the present composite cage cannot be recommended as a stand-alone device unless implant fixation will not be improved significantly. Evaluation of clinical and radiological long-term effects is essential to estimate the potential benefit of composite cages.Level Of Evidence2.

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