Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis
Abstract Background Currently, self-locking stand-alone cages (SSC) are commonly applied in anterior cervical discectomy and fusion (ACDF), as are cage-plate constructs (CPC). However, it remains controversial concerning the long-term effectiveness of both apparatuses. Our purpose is to compare long...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-06-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03885-4 |
| _version_ | 1797811365390319616 |
|---|---|
| author | Yu Zhang Jidong Ju Jinchun Wu |
| author_facet | Yu Zhang Jidong Ju Jinchun Wu |
| author_sort | Yu Zhang |
| collection | DOAJ |
| description | Abstract Background Currently, self-locking stand-alone cages (SSC) are commonly applied in anterior cervical discectomy and fusion (ACDF), as are cage-plate constructs (CPC). However, it remains controversial concerning the long-term effectiveness of both apparatuses. Our purpose is to compare long-term effectiveness of SSC with CPC in monosegmental ACDF. Methods Four electronic databases were queried to identify studies comparing SSC versus CPC in monosegmental ACDF. The meta-analysis was carried out with the use of the Stata MP 17.0 software package. Results Ten trials with 979 patients were included. Compared to CPC, SSC significantly reduced operative time, intraoperative blood loss, duration of hospitalisation, cervical Cobb angle at final follow-up, 1-month postoperative dysphagia rate, and incidence of adjacent segment degeneration (ASD) at final follow-up. No significant difference was found regarding 1-month postoperative cervical Cobb angle, JOA scores, NDI scores, fusion rate and cage subsidence rate at final follow-up. Conclusion Both devices achieved similar long-term effectiveness in monosegmental ACDF regarding JOA scores, NDI scores, fusion rate and cage subsidence rate. SSC had significant advantages over CPC in reducing surgical duration, intraoperative bleeding, duration of hospitalisation, as well as rates of dysphagia and ASD after surgery. Therefore, SSC is a better option than CPC in monosegmental ACDF. However, SSC is inferior to CPC in maintaining cervical curvature at long-term follow-up. Whether radiological changes affect clinical symptoms needs confirmation in trials with longer follow-up. |
| first_indexed | 2024-03-13T07:22:37Z |
| format | Article |
| id | doaj.art-cad1d1cecc644af68b91c46738b037b9 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-13T07:22:37Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-cad1d1cecc644af68b91c46738b037b92023-06-04T11:34:31ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-06-0118111610.1186/s13018-023-03885-4Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysisYu Zhang0Jidong Ju1Jinchun Wu2Department of Orthopaedics, Jingjiang People’s Hospital, The Seventh Affiliated Hospital of Yangzhou UniversityDepartment of Orthopaedics, Jingjiang People’s Hospital, The Seventh Affiliated Hospital of Yangzhou UniversityDepartment of Orthopaedics, Jingjiang People’s Hospital, The Seventh Affiliated Hospital of Yangzhou UniversityAbstract Background Currently, self-locking stand-alone cages (SSC) are commonly applied in anterior cervical discectomy and fusion (ACDF), as are cage-plate constructs (CPC). However, it remains controversial concerning the long-term effectiveness of both apparatuses. Our purpose is to compare long-term effectiveness of SSC with CPC in monosegmental ACDF. Methods Four electronic databases were queried to identify studies comparing SSC versus CPC in monosegmental ACDF. The meta-analysis was carried out with the use of the Stata MP 17.0 software package. Results Ten trials with 979 patients were included. Compared to CPC, SSC significantly reduced operative time, intraoperative blood loss, duration of hospitalisation, cervical Cobb angle at final follow-up, 1-month postoperative dysphagia rate, and incidence of adjacent segment degeneration (ASD) at final follow-up. No significant difference was found regarding 1-month postoperative cervical Cobb angle, JOA scores, NDI scores, fusion rate and cage subsidence rate at final follow-up. Conclusion Both devices achieved similar long-term effectiveness in monosegmental ACDF regarding JOA scores, NDI scores, fusion rate and cage subsidence rate. SSC had significant advantages over CPC in reducing surgical duration, intraoperative bleeding, duration of hospitalisation, as well as rates of dysphagia and ASD after surgery. Therefore, SSC is a better option than CPC in monosegmental ACDF. However, SSC is inferior to CPC in maintaining cervical curvature at long-term follow-up. Whether radiological changes affect clinical symptoms needs confirmation in trials with longer follow-up.https://doi.org/10.1186/s13018-023-03885-4Cervical spinal fusionSelf-locking stand-alone cageSingle segmentLong-term effectivenessMeta-analysis |
| spellingShingle | Yu Zhang Jidong Ju Jinchun Wu Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Cervical spinal fusion Self-locking stand-alone cage Single segment Long-term effectiveness Meta-analysis |
| title | Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis |
| title_full | Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis |
| title_fullStr | Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis |
| title_full_unstemmed | Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis |
| title_short | Self-locking stand-alone cage versus cage-plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2-year follow-up: a systematic review and meta-analysis |
| title_sort | self locking stand alone cage versus cage plate fixation in monosegmental anterior cervical discectomy and fusion with a minimum 2 year follow up a systematic review and meta analysis |
| topic | Cervical spinal fusion Self-locking stand-alone cage Single segment Long-term effectiveness Meta-analysis |
| url | https://doi.org/10.1186/s13018-023-03885-4 |
| work_keys_str_mv | AT yuzhang selflockingstandalonecageversuscageplatefixationinmonosegmentalanteriorcervicaldiscectomyandfusionwithaminimum2yearfollowupasystematicreviewandmetaanalysis AT jidongju selflockingstandalonecageversuscageplatefixationinmonosegmentalanteriorcervicaldiscectomyandfusionwithaminimum2yearfollowupasystematicreviewandmetaanalysis AT jinchunwu selflockingstandalonecageversuscageplatefixationinmonosegmentalanteriorcervicaldiscectomyandfusionwithaminimum2yearfollowupasystematicreviewandmetaanalysis |