Material and Method: Clinical and radiographic results of 16 patients (6 women and 10 men) between January 2006 and June 2009 with follow-up more than 24 months were evaluated. Spinal curvature, segmental sagittal angulations, construct height and the radiographic fusion success rate were measured. Odom’s criteria, visual analog scale (VAS), Nurick and modifi ed JOA (Japanese Orthopedic Association) score were used to assess the clinical results.

Results: There was signifi cant difference between pre- and post-operative in degree of lordosis, segmental Cobb angle and clinical outcomes (p < 0.01). Clinical outcomes were classifi ed as ‘excellent’ or ‘good’ according to Odom’s criteria in 14 patients (success rate: 87.5%). Mean follow-up period was 36 months. Flexion and extension lateral radiographs showed 100% fusion rate. The construct height and sagittal alignment were maintained on the fi nal follow-up observations. No cage failure, subsiding or dislodgement was showed on follow-up radiographs.

Conclusion: Interbody fusion with PEEK cages packed with bone substitute and aspirated bone marrow which additions of cervical plate eliminate the complications of graft harvest and is a good option for the treatment of patients with three and four levels degenerative cervical spondylosis.

Keywords: Three and four levels degenerative cervical spondylosis, ACDF, PEEK cage, Anterior cervical plate, Aspirated bone marrow