Multiple Level Anterior Cervical Discectomy and Fusion with PEEK Cage without Plating: Clinical Outcomes

Abstract Background: Anterior cervical discectomy and fusion is a common procedure done to treat cervical disk disease. The role of plating in the treatment of multilevel disc disease in the absence of instability has been debated with some claiming no difference in the clinical outcomes. Objective: The aim of the study was to assess the long term clinical outcomes of patients who underwent two or three level discectomies with PEEK cage placement without plating. Material and Methods: We collected the required data of all patients. Patients were contacted and completed clinical outcome questionnaires including NDI and VAS-Neck. All data was tabulated and statistical analysis was done. Results: Data of 72 patients was collected. The average age of the patients was 52.73 years. The mean follow-up was 62.4 months. 37 patients presented with Myelopathy (51%), 24 with radiculopathy (33%), 11 with myeloradiculopathy. The average VAS scores for neck pain preoperatively was 6.29 (Range: 4–9) and postoperatively improved to an average of 3.18 (Range: 0–7). The average neck disability index preoperatively was 37.86 (Range: 28–47) and the average postoperative NDI score being 19.02 (Range: 9 to 28). Our patients had a preoperative mean mJOA score of 11.68 (Range:3–17) and a mean postoperative mJOA score of 14.66 (3–17) with a mean difference of 3 points. Conclusion: The clinical outcomes of multiple-level cervical fusion without plating and with plating are similar. The best surgical option is one that requires minimal disruption of normal tissue, simple in technique and provides the patient with immediate- and long-term relief.