ABSTRACT
Introduction: An anterior cervical discectomy and fusion (ACDF) is a surgical procedure for treating symptomatic cervical disc disorders (CDDs). It involves neural tissue decompression, removing disc material osteophytes and ossified ligaments, and stabilizing decompressed segments with cages. ACDF is indicated for disorders such as chronic cervical disc herniation, cervical spondylosis, cervical stenosis and cervical disc degeneration with radiculopathy or myelopathy. Different types of cages are available for ACDF, including Titanium (Ti) cages, Polyetheretherketone (PEEK) cages, and carbon fiber-reinforced polymer (CFRP) cages. PEEK cages are biocompatible, radiolucent and possess a modulus of elasticity similar to that of human cortical bone hence believed to improve fusion rates and allow for more accurate assessment with CT scan. However, PEEK cages can lead to complications such as cage subsidence, migration, adjacent segment disease, non-union, and kyphosis. There is insufficient evidence to support PEEK cages as the most effective interbody devices, and recent articles have shown adverse radiographic endplate changes when using PEEK cages, potentially resulting in nonunion.