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Use of a polymethylmethacrylate cervical cage in the treatment of single-level cervical disc disease.

OBJECT
Polymethylmethacrylate (PMMA) bone cement has been used as a spacer in the treatment of patients with cervical disc disease with good long-term outcomes, but solid bone fusion has not been demonstrated in all cases. To achieve cervical interbody fusion, the authors designed a modified PMMA cervical cage that they filled with spongy bone for the treatment of single-level cervical disc herniation.


METHODS
Sixty-three patients underwent anterior cervical microdiscectomy and implantation of a PMMA cervical cage filled with autograft cancellous bone and were followed for a minimum of 2 years. The fusion rates were 90.5 and 100% at the 6- and 12-month follow-up examinations, respectively. The mean intervertebral disc height gain was 3.4 +/- 1.9 mm when preoperative and 24-month postoperative values were compared. Neck pain, measured using the Huskissan visual analog scale (0 mm, no pain; 100 mm, worst possible pain), decreased from 71 +/- 13 mm at preoperative baseline to 28 +/- 17 at 6, 23 +/- 19 at 12, and 31 +/- 19 mm at 24 months. Based on the same scale, radicular pain decreased from 83 +/- 15 mm at preoperative baseline to 24 +/- 11 at 6, 27 +/- 13 at 12, and 22 +/- 11 mm at 24 months. The self-rated clinical outcome was excellent in 45 (71.4%) and good in 18 (28.6%) of the 63 patients.


CONCLUSIONS
The autograft cancellous bone-filled PMMA cage is safe and effective for cervical interbody fusion in the treatment of single-level cervical disc herniation and monoradiculopathy.