Studies comparing cervical titanium cages and PEEK cages are rare in the literature. Chou’s team retrospectively compared the results of anterior cervical fusion using titanium cages, PEEK cages and tricortical bone grafts 1). They noticed a better fusion rate and less subsidence in the PEEK cages group. However, the study only enrolled a small number of patients and cervical spinal function was not evaluated. In a systematic review by Kersten who compared a PEEK cage with a bone graft, titanium cage, and carbon fiber cage, no difference was found between PEEK and titanium cage 2).
A meta-analysis indicated no significant difference in functional and radiographic performance between the PEEK and titanium cages, although more subsidence occurred in the titanium cage group. More high-quality studies are needed to confirm these results to offer more information for the choice in clinical practice 3).