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

Abstract

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.

Clinical Outcomes between Stand-Alone Zero-Profile Spacers and Cervical Plate with Cage Fixation for Anterior Cervical Discectomy and Fusion: A Retrospective Analysis of 166 Patients

“…Similarly, a recent meta-analysis by Gabr et al demonstrated that stand-alone anchored spacers were associated with less dysphagia compared to the plate-screw construct [ 16 ]. Lastly, a systematic review by Boer et al showed that there was no difference in clinical (visual analog scale, neck disability index) or radiological (cervical lordosis and fusion) outcomes between the two groups, but stand-alone devices were associated with shorter operative time [ 17 ].…”

Stand-alone anterior cervical decompression and fusion surgery: A cohort study evaluating a shaped cage without plates or screws

“…In theory, an LSC could provide immediate load-bearing support to the anterior column of the cervical spine and may enhance the rate of arthrodesis. Previous studies reported that LSC provided comparable stability and reduced the damage to soft tissues and plate-related complications with a satisfactory clinical outcome (7)(8)(9)(10)(11)(12). Nevertheless, previously published studies showed that there were no advantages of LSC in clinical and/or radiologic outcomes and/or complications compared with APC (13,14).…”

Analysis of patient with cervical discopathy treated surgically on the own material of neurosurgical department

“…During almost 60 years of anterior access cervical discopathy, this method underwent many modifications. It became minimal invasive, instead of using initially taken blocks taken from the iliac bone, cage made of artificial substitutes such as titanium, PEEK was used [5,6]. Dynamic implants called artificial discs are also used, which maintain the mobility of the operated segment.…”