Clinical and Radiological Evaluation Between 3D Printed Titanium Cage and Polyetheretherketone Cage in Anterior Cervical Discectomy and Fusion: A Comparative Study With Mid-term Follow-Up

Study design Retrospective comparative cohort study. Objective To compare the clinical and radiological outcomes of 3D-printed titanium cages and PEEK cages in patients who underwent ACDF with mid-term follow-up. Methods A total of 127 patients were retrospectively reviewed, including 61 patients in the PEEK cage group and 66 patients in the 3D-printed titanium cage group (3D group). Surgical parameters, fusion status, complications, and patient-reported outcome measures (PROMs) were assessed serially. Results Operative time, blood loss and hospital stay were comparable between the two groups. The 3D group showed significantly higher fusion rates at 3-month and 6-month post-operatively. At the latest follow-up, patients in both groups achieved bony union. The overall complication incidence was 11.5% in the PEEK group and 7.6% in the 3D group, respectively. Significant improvements in radiological assessments and PROMs were observed in both groups. The 3D group exhibited less subsidence as well as statistically superior VAS neck pain, NDI, and SF-12 PCS scores. Conclusion Both the 3D group and the PEEK group yielded satisfactory outcomes following ACDF. Patients receiving 3D-printed titanium cages demonstrated statistically higher early fusion rates and lower subsidence. Statistically significant inter-group differences were noted in the final VAS neck pain scores, NDI scores, and SF-12 PCS scores. 3D-printed titanium cages represent a safe and reliable option for patients undergoing ACDF.