Comparative outcomes of polyetheretherketone cage versus autograft harvested from en bloc laminectomy in posterior lumbar interbody fusion for low-grade spondylolisthesis

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ABSTRACT Background: Lumbar spondylolisthesis often necessitates surgical intervention when conservative treatments fail. Posterior lumbar interbody fusion (PLIF) using either polyetheretherketone (PEEK) cages or autografts is a common approach, but their comparative outcomes remain unclear. This study compares the clinical and radiologic outcomes of these two techniques in patients with Grade 1 and 2 lumbar spondylolisthesis. Materials and Methods: In this retrospective cohort study, 101 patients underwent PLIF with either a PEEK cage ( n = 48) or autograft ( n = 53). Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiographic parameters, intraoperative metrics, and complications were also analyzed. Results: Preoperative characteristics, including VAS, ODI, and radiographic parameters, were similar between the groups ( P > 0.05). Postoperatively, the cage group showed significantly greater ODI improvement ( P = 0.012), while VAS scores were comparable ( P = 0.773). The cage group had higher intraoperative blood loss ( P = 0.022), but operative time, complications, and hospital stay were similar. Radiographically, the cage group achieved better local lumbar lordosis postoperatively ( P = 0.038). Conclusion: Both PEEK cages and autografts are effective for PLIF in low-grade spondylolisthesis, offering comparable pain relief and radiologic outcomes. PEEK cages provide better short-term functional improvement and segmental alignment but result in higher intraoperative blood loss.

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