A Comparative Study between Anterior Cervical discectomy, Fusion & Fixation with Iliac Crest Graft and Plating Versus PEEK Cage and Screws in Cervical Degenerative DISC Disease

Background: Anterior cervical discectomy and fusion (ACDF) is a standard surgical approach for cervical degenerative disc disease (CDDD). Traditional fusion using iliac crest graft with plating is widely practiced, whereas polyetheretherketone (PEEK) cages with screws offer an alternative that may reduce donor-site morbidity and operative complications. This study compares clinical outcomes, complications, and radiological parameters between the two techniques. Methods: A prospective comparative study was conducted on 100 patients diagnosed with single or two-level cervical degenerative disc disease. Patients were divided into two groups: ACDF with iliac crest graft and plating (n=50) and ACDF with PEEK cage and screws (n=50). Demographic data, operative parameters, post-operative complications, Visual Analog Scale (VAS) for pain, and radiation exposure were recorded and analyzed. Results • Demographics: Mean age was 44.44 ± 10.79 years in the plating group and 41.86 ± 11.24 years in the PEEK group. Male predominance was observed in both groups (74% vs. 66%). • Diagnosis Distribution: Most commonly affected level was C5-6 (54% vs. 58%). • Complications: Hoarseness, stitch abscess, mild dysphagia, persistent symptoms, and wound infection were minimal in both groups. No complications were observed in 43 (86%) of the plating group and 49 (98%) of the PEEK group. • Pain Outcomes: Mean post-operative VAS scores were significantly reduced in both groups at 3, 6, and 12 months, with slightly lower scores in the PEEK group at 3 and 6 months (p<0.05). • Radiation Exposure: ACDF with plating required more intraoperative fluoroscopy compared to PEEK cage (94% vs. 2% requiring ≥5 shots). Conclusion: The PEEK Cage group showed better post operative pain control,fewer donar site complitions. PEEK cage is an safe and efficient technique.