Advantages and Disadvantages of the Use of Various Types of Interbody Implants in Cervical Spine Surgery. Critical Review of the Literature

Background. Most cervical spine procedures in patients with degenerative disc disease involve discectomy and remo­val of osteophytes in posterior vertebral body surfaces followed by interbody stabilisation with an interbody implant. Interbody implants are made of a variety of materials, differing in structural design, shape and surface topography. Considering that fusion between the implant and host bone is crucial for long-term positive outcomes, the choice of an appropriate implant is significantly important clinically and continues to be an important area of study. Material and methods. Relevant published studies indexed by Medline were identified via PubMed and reviewed. The findings were combined with the authors’ experiences. The database query was based on keywords related to implants in cervical spine surgery. This article presents the currently most popular types of implants by describing their properties and indicating their strengths and weaknesses as well as differences between different implant types. Results. Currently, the most popular interbody cages in cervical spine surgery are polyetheretherketone (PEEK) im­plants, titanium-coated PEEK implants and titanium implants. Besides the type of material used, the shape and surface structure of an implant appear to be of significant importance for a successful bony fusion. Conclusions. 1. 3D printing and the ability to produce 3-dimensional porous-surfaced implants opens up considerable pro­spects for this technique in the production of modern interbody implants. 2. Implants that facilitate the engagement (interlocking) of greater volumes of bone (e.g. porous implants) offer better implant fixation, with the type of material used being less important.