Comparison of Bone Graft with Plate vs Zero-Profile PEEK Cage for Anterior Cervical Discectomy and Fusion

Abstract

Background: Anterior cervical discectomy and fusion (ACDF) is a widely used procedure for cervical disc disease, employing either bone graft with anterior plating or zero-profile PEEK cages. While both approaches aim to achieve spinal stability and neural decompression, their comparative effectiveness in clinical and operative outcomes remains under debate. Objective: To compare the radiological and clinical outcomes of ACDF using bone graft with anterior plate versus zero-profile PEEK cage. Methods: This prospective comparative study enrolled 60 patients with cervical disc herniation who underwent single- or two-level ACDF. Group A received bone graft with anterior plate, while Group B received zero-profile PEEK cages. Outcomes assessed at 3 and 6 months included fusion rates, disc height, segmental lordosis, Neck Disability Index (NDI), Visual Analog Scale (VAS) scores, operative time, and intraoperative blood loss. Statistical analysis was performed using SPSS v25.0 with a significance level of p < 0.05. Results: Fusion rates were similar between groups (93.3% vs. 86.7%, p = 0.38). Group A showed better lordosis (p = 0.02), while Group B had lower NDI (p = 0.00), neck pain (p = 0.04), operative time (p = 0.00), and blood loss (p = 0.00). Conclusion: Both ACDF techniques are effective, but zero-profile PEEK cages offer superior clinical recovery, reduced invasiveness, and operative efficiency.