A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures

Panchal, Ripul R.; Kim, Kee D.; Eastlack, Robert K.; Lopez, John; Clavenna, Andrew; Brooks, Daina M.; Joshua, Gita

doi:10.1016/j.wneu.2016.12.060

Cited by 21 publications

(39 citation statements)

References 22 publications

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“…Bone consolidation was reported in 5 of the studies analyzed, with percentages ranging from 88.9% to 100%. 16,[18][19][20][21] These results indicate that there is no significant difference between the surgical techniques, which is apparent in the similar estimates of the odds ratio (OR) (fixed: OR ¼ 1.36 and 95% CI ¼ Figure 6. In the evaluation of heterogeneity, I 2 and Q estimates of 63.12% and 12.69, respectively, culminate in a P value of .0055.…”

Section: Radiological Resultsmentioning

confidence: 68%

“…The angle of cervical lordosis was described in 3 of the analyzed works. 18,20,21 Figure 7 clearly shows a significant increase in the angle for the PLATE group (mean difference ¼ 1.94; 95% CI ¼ [0.15, 3.74]) and heterogeneity (I 2 ¼ 87.15%; Q ¼ 15.56, P ¼ .0004).…”

Section: Radiological Resultsmentioning

confidence: 99%

“…Fusion was evaluated by x-ray in all included studies [16][17][18][19][20][21] ; however, 3 studies also used computed tomography (CT) scans 17,18,21 and 1 study included MRI in the fusion evaluation. 18…”

Section: Radiological Resultsmentioning

confidence: 99%

“…Again, heterogeneity was found (I 2 ¼ 97.47%; Q ¼ 315.18, P < .001). Figure 5 shows that there was no significant difference between the 2 procedures compared using the NDI scale (mean difference ¼ À0.70; 95% CI ¼ [À1.88, 0.47]; P ¼ .04), present in 4 clinical trials [17][18][19][20] with evident heterogeneity between the studies (I 2 ¼ 98.45%; Q ¼ 258.34; P < .001).…”

Section: Pain Scalesmentioning

confidence: 99%

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Degenerative Cervical Disorder—Stand-alone Cage Versus Cage and Cervical Plate: A Systematic Review

Boer

Zorzetto

Yeh

et al. 2020

Global Spine Journal

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Study Design: Systematic review. Objectives: The objective of this study was to compare clinical and radiological outcomes following discectomy and anterior cervical fusion for the treatment of cervical degenerative disorder performed with stand-alone cages and anterior cervical plates. Methods: Electronic searches were performed in the MEDLINE, LILACS, and Cochrane Systematic Reviews databases, according to PRISMA guidelines, with no language or date restriction. The review was registered in PROSPERO under number CRD42018109180. Results: Six randomized clinical trials were selected, which evaluated at least one of the objectives of this work, such as pain control, bone consolidation, neurological symptoms, and cervical lordosis, thus satisfying the inclusion criteria. Articles that did not directly compare the 2 surgical techniques were excluded. A total of 309 patients were included and the results showed no significant difference in clinical (visual analogue scale and neck disability index) or radiological (cervical lordosis and fusion) outcome between the 2 groups. The operative time was shorter in the group with stand-alone cages (mean difference = −18.40; 95% CI = [−24.89, −11.92]; P < .66). Conclusion: The stand-alone cages and anterior cervical plate techniques have similar clinical and radiological outcomes. Despite the significantly shorter operative time for one group, other randomized clinical trials are needed to establish conclusive evidence in favor of one of the comparative treatments.

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Section: Radiological Resultsmentioning

confidence: 68%

Section: Radiological Resultsmentioning

confidence: 99%

Section: Radiological Resultsmentioning

confidence: 99%

Section: Pain Scalesmentioning

confidence: 99%

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Degenerative Cervical Disorder—Stand-alone Cage Versus Cage and Cervical Plate: A Systematic Review

Boer

Zorzetto

Yeh

et al. 2020

Global Spine Journal

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“…In a prospective randomized study, the stand-alone anchored PEEK cage was confirmed as a valid alternative to plating in ACDF with a low rate of adjacent-level ossification (39). ACDF with standalone spacers has resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia (40). As regards to three-level cervical degenerative spondylopathy, ACDF using self-locking stand-alone cages have shown similar clinical results as compared to ACDF using cages and plate fixation (41).…”

Section: Discussionmentioning

confidence: 98%

Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

Kapetanakis¹,

Thomaidis²,

Charitoudis³

et al. 2017

J. Spine Surg.

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Background: Anterior cervical discectomy and fusion (ACDF) constitutes the conventional treatment of cervical disc herniation due to degenerative disc disease (DDD). ACDF with plating presents a variety of complications postoperatively and stand-alone cages are thought to be a promising alternative. The aim of this study was firstly, to analyze prospectively collected data from a sample of patients treated with single ACDF using C-Plus self-locking stand-alone PEEK cage system, without the use of plates or screws, in order to evaluate pain levels of patients, utilizing Neck and Arm Pain scale as an expression of visual analogue scale (VAS). Secondly, we aimed to evaluate health-related quality of life, via the short-form 36 (SF-36) and Neck Disability Index (NDI).Methods: Thirty-six patients (19 male and 17 female) with mean age 49.6±7 years old who underwent successful single ACDF using self-locking stand-alone PEEK cage for symptomatic cervical DDD were selected for the study. Neck and Arm pain, as well as SF-36 and NDI were estimated preoperatively and 1, 3, 6, and 12 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological and radiological evaluation. Results:The clinical and radiological outcomes were satisfactory after a minimum 1-year follow-up.All results were statistically important (P<0.05), excluding improvement in NDI measured between 6 and 12 months. SF-36, Neck Pain, as well as Arm Pain featured gradual and constant improvement during follow-up, with best scores presenting at 12 months after surgery, while NDI reached its best at 6 months postoperatively.Conclusions: Generally, all scores showed improvement postoperatively during the different phases of the follow-up. Subsequently, ACDF using C-Plus cervical cage constitutes an effective method for cervical disc herniation treatment, in terms of postoperative improvement on pain levels and health-related quality of life and a safe alternative to the conventional method of treatment for cervical DDD.

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Locking stand-alone cage versus anterior plate construct in anterior cervical discectomy and fusion: a systematic review and meta-analysis based on randomized controlled trials

et al. 2020

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Purpose To evaluate the efficacy of locking stand-alone cage (LSC) compared with anterior plate construct (APC) in anterior cervical discectomy and fusion (ACDF). Methods A comprehensive literature search was carried out in PubMed, Embase, Web of Science, and Cochrane Library to screen randomized controlled trials (RCTs) that directly compared LSC with APC in ACDF. The Cochrane Collaboration's tool was used for assessment of study quality. Data were analyzed with the Review Manager 5.3 software. Results A total of seven RCTs were included. The results revealed no significant differences between LSC and APC in ACDF regarding the fusion rate, Japanese Orthopaedic Association score, visual analogue scale score, neck disability index score, hospital stay, subsidence rate, cervical lordosis, segmental Cobb angle, and disc height. However, LSC was associated with a significantly shorter operation time, less blood loss, lower overall incidence of dysphagia, and lower adjacent-level ossification (ALO) rate compared with APC. Conclusion In summary, LSC is not only a safe and effective device for ACDF but also has the advantages of significantly reduced operation time, blood loss, overall incidence of dysphagia, and ALO rate over APC. Therefore, LSC is a better alternative than APC for the patients undergoing ACDF procedures.

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A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures

Cited by 21 publications

References 22 publications

Degenerative Cervical Disorder—Stand-alone Cage Versus Cage and Cervical Plate: A Systematic Review

Degenerative Cervical Disorder—Stand-alone Cage Versus Cage and Cervical Plate: A Systematic Review

Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life

Locking stand-alone cage versus anterior plate construct in anterior cervical discectomy and fusion: a systematic review and meta-analysis based on randomized controlled trials

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