Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study
Abstract Background Anterior cervical discectomy and fusion has been considered standard management for cervical myelopathy and radiculopathy. However, the option of using self-locking stand-alone cages or cage-with-plate in three-level anterior cervical discectomy and fusion still remains controver...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03726-4 |
| _version_ | 1797849959493533696 |
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| author | Liang Tang Xiaoming Liu Yanghu Lu Yanbin Liu Jiangming Yu Jian Zhao |
| author_facet | Liang Tang Xiaoming Liu Yanghu Lu Yanbin Liu Jiangming Yu Jian Zhao |
| author_sort | Liang Tang |
| collection | DOAJ |
| description | Abstract Background Anterior cervical discectomy and fusion has been considered standard management for cervical myelopathy and radiculopathy. However, the option of using self-locking stand-alone cages or cage-with-plate in three-level anterior cervical discectomy and fusion still remains controversial. The aim of this study was to evaluate the clinical and imaging outcomes of the two procedures in multilevel anterior cervical discectomy and fusion. Methods Sixty-seven patients who underwent three-level anterior cervical discectomy and fusion were enrolled in this study, of which 31 patients underwent surgery using self-locking stand-alone cages (group cage) and 36 patients using cage-with-plate (group plate). For the evaluation of clinical outcomes, modified Japanese Orthopedic Association scores, visual analogue scale for neck pain, neck disability index, Odom’s criteria and dysphagia status were measured. Imaging outcomes were evaluated by cervical sagittal angle, fusion segmental Cobb’s angle, fusion segmental height, range of motion, cage subsidence rate, fusion rate and adjacent segment degeneration. Statistical analyses were performed using the SPSS software (version 19.0). Results Both groups showed improvement in modified Japanese Orthopedic Association scores, visual analogue scale for neck pain and neck disability index, after surgery, and there was no significant difference between the groups. The occurrence rate of dysphagia is significantly lower in the group cage compared with the group plate (p < 0.05). The postoperative cervical sagittal angle, fusion segmental Cobb’s angle, fusion segmental height and cage subsidence rate in the group plate were significantly superior to that in the group cage (p < 0.05). However, the rate of adjacent segment degeneration was significantly lower in the group cage compared with the group plate (p < 0.05). Both groups showed no significant difference in terms of fusion rate (p > 0.05). Conclusions The self-locking stand-alone cages are effective, reliable and safe in anterior cervical discectomy and fusion for the treatment of cervical myelopathy and radiculopathy. Self-locking stand-alone cages showed a significantly lower rate of dysphagia and adjacent segment degeneration, while anterior cervical cage-with-plate could provide stronger postoperative stability and maintain better cervical spine alignment. |
| first_indexed | 2024-04-09T18:52:38Z |
| format | Article |
| id | doaj.art-48c14ea714b647d7985a7999b0a31b5f |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T18:52:38Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-48c14ea714b647d7985a7999b0a31b5f2023-04-09T11:22:36ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-04-0118111110.1186/s13018-023-03726-4Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative studyLiang Tang0Xiaoming Liu1Yanghu Lu2Yanbin Liu3Jiangming Yu4Jian Zhao5Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Second Affiliated Hospital of Naval Medical UniversityAbstract Background Anterior cervical discectomy and fusion has been considered standard management for cervical myelopathy and radiculopathy. However, the option of using self-locking stand-alone cages or cage-with-plate in three-level anterior cervical discectomy and fusion still remains controversial. The aim of this study was to evaluate the clinical and imaging outcomes of the two procedures in multilevel anterior cervical discectomy and fusion. Methods Sixty-seven patients who underwent three-level anterior cervical discectomy and fusion were enrolled in this study, of which 31 patients underwent surgery using self-locking stand-alone cages (group cage) and 36 patients using cage-with-plate (group plate). For the evaluation of clinical outcomes, modified Japanese Orthopedic Association scores, visual analogue scale for neck pain, neck disability index, Odom’s criteria and dysphagia status were measured. Imaging outcomes were evaluated by cervical sagittal angle, fusion segmental Cobb’s angle, fusion segmental height, range of motion, cage subsidence rate, fusion rate and adjacent segment degeneration. Statistical analyses were performed using the SPSS software (version 19.0). Results Both groups showed improvement in modified Japanese Orthopedic Association scores, visual analogue scale for neck pain and neck disability index, after surgery, and there was no significant difference between the groups. The occurrence rate of dysphagia is significantly lower in the group cage compared with the group plate (p < 0.05). The postoperative cervical sagittal angle, fusion segmental Cobb’s angle, fusion segmental height and cage subsidence rate in the group plate were significantly superior to that in the group cage (p < 0.05). However, the rate of adjacent segment degeneration was significantly lower in the group cage compared with the group plate (p < 0.05). Both groups showed no significant difference in terms of fusion rate (p > 0.05). Conclusions The self-locking stand-alone cages are effective, reliable and safe in anterior cervical discectomy and fusion for the treatment of cervical myelopathy and radiculopathy. Self-locking stand-alone cages showed a significantly lower rate of dysphagia and adjacent segment degeneration, while anterior cervical cage-with-plate could provide stronger postoperative stability and maintain better cervical spine alignment.https://doi.org/10.1186/s13018-023-03726-4Multilevel anterior cervical discectomy and fusionSelf-locking stand-alone cageAnterior cage-with-plateCervical spondylosis |
| spellingShingle | Liang Tang Xiaoming Liu Yanghu Lu Yanbin Liu Jiangming Yu Jian Zhao Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study Journal of Orthopaedic Surgery and Research Multilevel anterior cervical discectomy and fusion Self-locking stand-alone cage Anterior cage-with-plate Cervical spondylosis |
| title | Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study |
| title_full | Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study |
| title_fullStr | Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study |
| title_full_unstemmed | Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study |
| title_short | Clinical and imaging outcomes of self-locking stand-alone cages and anterior cage-with-plate in three-level anterior cervical discectomy and fusion: a retrospective comparative study |
| title_sort | clinical and imaging outcomes of self locking stand alone cages and anterior cage with plate in three level anterior cervical discectomy and fusion a retrospective comparative study |
| topic | Multilevel anterior cervical discectomy and fusion Self-locking stand-alone cage Anterior cage-with-plate Cervical spondylosis |
| url | https://doi.org/10.1186/s13018-023-03726-4 |
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