A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

Kim, Sam Yeol; Yoon, Seung Hwan; Kim, Do-Keun; Oh, Chang Hyun; Oh, Seungjong

doi:10.3340/jkns.2017.0211

Cited by 26 publications

(38 citation statements)

References 31 publications

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“…In a study by Kim et al ., who similarly evaluated ACDF with cage-only and ACDF-CP in one level and two levels, postoperative NDI in cage-only in one level group was lower than the CP group. [ 10 ] Comparison of NDI after surgery in two levels did not demonstrate significant differences in both groups. These findings are consistent with the results of our study.…”

Section: Discussionmentioning

confidence: 94%

“…[ 9 ] The presence of the plate helps maintain the stability of the fusion structure, and the CA method is more beneficial in terms of ease of use plus reducing surgical time and blood loss. [ 10 ] Comparison of CA with CP has revealed different results in several studies. Some studies have shown higher levels of fusion and decreased subsidence levels in the CP technique than the CA method.…”

Section: Introductionmentioning

confidence: 99%

“…[ 11 12 ] Some other studies have reported the absence of any differences between the two methods. [ 10 13 ] In other studies, reduction in complications such as dysphagia and the possibility of early postoperative discharge are discussed as the superiority aspects of the CA method. [ 14 ] Considering the differences between the results of similar studies and the limited number of studies which compared these two methods in one and two levels, the purpose of the current study was to evaluate the outcomes of treating patients with spinal lesions in one level or two levels through ACDF-CA and ACDF-CP methods and compare these results with each other.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the outcomes of cage-stand-alone with cage-with-plate fixation in one level and two levels for treating cervical disk diseases

Etemadifar

Andalib

Shafiee

et al. 2018

J Craniovert Jun Spine

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Introduction:Anterior cervical discectomy and fusion (ACDF) surgery is an accepted method for many spinal cord abnormalities. The purpose of this study was to evaluate the outcomes of treating patients with spinal cord lesions at one level or two levels through ACDF with cage-stand-alone (ACDF-CA) and ACDF with cage-with-plate fixation (ACDF-CP) surgery and comparing these results with each other.Methods:In this prospective, cross-sectional, descriptive study, eighty patients undergoing ACDF surgery were enrolled according to the inclusion and exclusion criteria. Demographic data, before and after surgery findings, and clinical symptoms were investigated. Data were collected by means of visual analog scale (VAS) and Neck Disability Index (NDI) questionnaires. The adverse effects and surgical outcomes were evaluated based on Odom's criteria and patients’ satisfaction. The collected data of the groups were then compared and assessed.Results:There was no significant difference between the groups in regards of gender, age, duration of surgery to visit, surgical level, preoperative and postoperative VAS and cervical range of motion, preoperative NDI, results based on Odom's criteria, and satisfaction of patients (P > 0.05). The VAS, NDI, and range of motion scores were significantly reduced in the four groups after the operation compared to the preoperative stage. Postoperative NDI scores in the ACDF-CA group at one level were significantly lower than other groups (P < 0.05).Conclusion:Both of the methods revealed acceptable outcomes in comparison to the preoperative stage, and despite some minor differences, there are generally no significant differences in outcomes and complications.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the outcomes of cage-stand-alone with cage-with-plate fixation in one level and two levels for treating cervical disk diseases

Etemadifar

Andalib

Shafiee

et al. 2018

J Craniovert Jun Spine

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“…Subsidence was defined as a decrease of ASH by more than 2 mm on the lateral radiographs during the follow-up period 6,13) . The SCA was measured as the angle between the superior endplate of the upper vertebra body and the lower endplate of the lower vertebra body.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

Subsidence after Anterior Cervical Interbody Fusion Using a Zero-Profile Device

Kang¹,

Oh²,

Cho³

2019

Nerve

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Zero-profile device (Zero-P) has generally been used as a stand-alone cage in anterior cervical discectomy and fusion (ACDF). However, using Zero-P has been reported to be associated with a high subsidence rate. The present study evaluates the factors that influence the subsidence of ACDF. Methods: Records of a total of 29 patients with degenerative spondylosis resulting in radiculopathy or myelopathy between C2 and C7 who underwent ACDF with Zero-P were retrospectively reviewed. The participants received 1 or 2 level ACDF with Zero-P in our clinic from December, 2011 to December, 2017. A total of 35 treatment levels were included in the analysis. Subsidence was defined when anterior segmental heights decreased by more than 2 mm during the follow-up period. The patients were divided into the subsidence and non-subsidence groups. The following factors were investigated in relation to the occurrence of subsidence: age, gender, body mass index, diabetes mellitus, cage height, perioperative distraction, segmental lordosis, pain score, fusion grade, anterior/posterior segmental height ratio, and cage distance. Results: Cage subsidence was observed in 15 cases (15/35, 42%). Cage distance at immediate postoperation was significantly different between the 2 groups; specifically, while the group with subsidence had 2.66±1.62 mm distance, the group without subsidence had 1.24±1.13 mm distance (p=0.008). Conclusion: This study confirms that the more deeply titanium part is inserted at the anterior edge, the more subsidence occurs. In order to decrease the occurrence of cage subsidence, Zero-P cages should be located the closest possible to the anterior rim of vertebral body at operation.

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“…The necessity, however, of this technique has been questioned over the years since similar results can be achieved employing the stand-alone technique, especially in one- or two-level surgery. [ 2 3 ] The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF without the use of an anterior plate.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?

Theologou

Skoulios

et al. 2020

Asian J Neurosurg

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Background: Anterior cervical discectomy with fusion (ACDF) is a proven method for the treatment of selected patients. The necessity of use of an anterior plate is controversial. The article aims to assess the fusion rates (FRs) and long-term outcomes following three-level ACDF. Materials and Methods: Data were collected from the medical records of patients operated on due to degenerative cervical disease. All patients were treated with three-level ACDF employing polyether ether-ketone cages without anterior plating. Visual analog scale (VAS), neck disability index (NDI), and plain radiographs were used in the clinical and radiological postsurgery assessment. Fusion evaluation was performed according to the <1 mm motion between spinous processes rule. Subsidence was defined as a more than 2 mm decrease in the interbody height. Results: A total of 234 treated levels on 78 patients were assessed. The mean presurgery NDI score was 23.07 ± 4.86, with a mean disability of 46.03% ± 9.64. The mean presurgery VAS score of the neck was 7.58 ± 0.85, while VAS score of the arm was 7.75 ± 1.008. Post surgery, NDI stated no disability, while VAS score of the neck and arm showed no presence of pain. The mean FR was 19.50 ± 21.71 levels per month, with a peak from 3 rd to 6 th month. Presurgery evaluation showed 12 (15.38%) patients with a high T2 sequence signal. Magnetic resonance imaging screening detected 31 (39.24%) patients with coexisting cervical and lumbar findings. Post surgery, transient dysphagia was reported by 1 patient (1.28%), while subsidence was registered in 15 (6.41%) levels, situated in 12 patients (15.38%), most often at C 6-7 (66.6%). Clinical and radiological follow-up extended to 69.47 ± 11.45 months. Conclusion: Multilevel stand-alone ACDF is a safe, cost-effective procedure providing favorable clinical and radiological results with minimal complications. The incidence of subsidence is usually clinically insignificant and can be decreased with a careful surgical technique.

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A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

Cited by 26 publications

References 31 publications

Comparison of the outcomes of cage-stand-alone with cage-with-plate fixation in one level and two levels for treating cervical disk diseases

Comparison of the outcomes of cage-stand-alone with cage-with-plate fixation in one level and two levels for treating cervical disk diseases

Subsidence after Anterior Cervical Interbody Fusion Using a Zero-Profile Device

Long-term outcome following three-level stand-alone anterior cervical discectomy and fusion: Is plating necessary?

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