Vertebral endplate cavities (VECs) after microscopic assisted anterior cervical discectomy and fusion (ACDF) with polyetheretherketone (PEEK) cages

Abstract Study design: A retrospective CT- based study Objectives: The aim is to assess the prevalence of vertebral endplate cavities VEC after ACDF using PEEK cages by CT, and to estimate their impact on fusion. Methods: The term “cavity” was used to describe the endplate changes. CT analysis of the VECs and fusion status following ACDF with PEEK cages was conducted by two observers. VECs were assessed according to the size, multiplicity, location, and presence of sclerosis. Results: A total of 46 consecutive (20 males and 26 females) were enrolled in the study. The mean age at surgery was 50.43±11.37 years. A total of 96 levels were fixed. The mean follow-up was 30.87± 25.371 months (range, 6–96 months). VECs were found at 30 levels (31.3%) by both observers. The level of agreement was regarded as almost perfect. All the VECs were small (<5 mm) Definite fusion was seen in 50 levels (52.1%) by observer 1 versus 52 levels (54.2%) by observer 2. The level of agreement was regarded as almost perfect. With both observers, the presence of VECs was significantly related to the fusion status (p ≤ 0.05). However, the follow-up period, the levels, age, sex and cigarette smoking had no statistical significance with fusion status. Conclusion: Our study confirmed the existence of VECs following ACDF using PEEK cages in about one third of our patients (31.3%). These VECs tend to be small (<5 mm) in size and might be associated with non-union.