ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Anterior cervical discectomy and fusion without anchoring: a multicenter comparison of stand-alone porous titanium versus anchored PEEK interbody cages.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare clinical and radiological outcomes of ACDF performed using stand-alone 3D-printed porous titanium cages versus anchored polyetheretherketone (PEEK) interbody cages in patients with degenerative cervical spine disease.
methodsThis multicenter retrospective study included consecutive adult patients who underwent single- or two-level ACDF between January 2020 and October 2024. Patients were treated with either stand-alone porous titanium cages or anchored zero-profile PEEK cages. Clinical outcomes were assessed using the NRS and the SF-12 questionnaire. Radiological outcomes included intersomatic fusion, cage subsidence, and sagittal alignment parameters. Fusion was evaluated on static cervical radiographs at 12 months. Complications and revision surgeries were recorded.
resultsA total of 265 patients were included (121 stand-alone; 144 anchored). Baseline demographic and clinical characteristics were comparable between groups. Operative time was significantly shorter in the stand-alone group (85 vs. 112 min). Both groups showed significant postoperative improvement in pain and functional scores. The magnitude of pain reduction was greater in the stand-alone cohort, while SF-12 improvement was comparable. Fusion rates (88.4% vs. 92.3%), subsidence rates (5.7% vs. 4.1%), complication rates, and sagittal alignment parameters did not differ significantly between groups. Osteoporosis was the only factor associated with an increased risk of cage subsidence.
conclusionIn this multicenter study, stand-alone 3D-printed porous titanium cages achieved clinical and radiological outcomes comparable to anchored PEEK cages in ACDF, with shorter operative times, preserved sagittal alignment, and similar complication, fusion, and subsidence rates. These findings support their use as a safe and efficient alternative in appropriately selected patients.
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