జర్నల్ ఆఫ్ స్పైన్ & న్యూరోసర్జరీ

Posterior Lumbar Interbody Fusion Using a Porous PEEK Implant and Bone Marrow Concentrate

Paul R Waldrop1, Christopher R Rehak2 and J Kenneth Burkus3*

Objective: We report the 1-year results of a prospective, singlecenter clinical study in which a posterior lumbar interbody fusion (PLIF) was performed using a novel porous polyether ether ketone (PEEK) implant and pedicle screw fixation in patients with symptomatic single-level degenerative lumbar disc disease.

Methods: Thirty consecutive patients with single-level symptomatic degenerative lumbar disc disease were enrolled in the study. All patients underwent a single level PLIF procedure using a porous PEEK implant with pedicle screw fixation and bone marrow concentrate applied to a ceramic carrier. Patients were assessed preoperatively and at 1.5, 3, 6, and 12 months after surgery. Standardized outcome measures were used to evaluate the patient’s condition before and after surgery. Plain radiographs were used to assess fusion, sagittal plane angulation, bony ingrowth, subsidence, and migration of the implant.

Results: Three patients were lost to follow up after their 3-month follow-up visits and were removed from the study; 27 patients were followed for a minimum of 12 months. At their last follow up, Oswestry disability index (ODI) scores and back and leg pain scores showed improvement in all patients. All patients showed radiographic fusion with no motion across the instrumented interspaces on dynamic flexion-extension lateral radiographs. Segmental lordosis at the surgical site improved from -1° to an average of -7° (0° to -9°) with no evidence of implant migration or subsidence. Average disc space height increased 6 mm. No patient showed radiographic evidence of a pseudarthrosis. No patient developed radiolucency at the implant interface with the host bone.

Conclusion: We found that used of a porous-surface PEEK implant with bone marrow concentrate on a ceramic carrier is a clinically viable alternative for improving the osseointegration and fusion rates in patients undergoing single-level PLIF surgery for degenerative disc disease in the lumbar spine.