Outcomes of cervical degenerative disc disease treated by anterior cervical discectomy and fusion with self-locking fusion cage

Abstract

BACKGROUND Cervical degenerative disc (CDD) disease is a common type of spondylosis. Although anterior cervical discectomy and fusion (ACDF) is the preferred treatment for CDD disease, internal fixation with a titanium plate may cause various complications. The invention of the ACDF with a self-locking fusion cage (ROI-C) has effectively decreased the incidence of postoperative complications. AIM To observe the outcomes of CDD disease treated by ACDF with a ROI-C. METHODS Ninety patients with CDD disease treated at our hospital from March 2019 to March 2021 were included. They were divided into two groups (control group and observation group, n = 45 in each) using a random number table. Patients in the control group received ACDF plus internal fixation with a titanium plate. Those in the observation group received ACDF + ROI-C placement. The two groups of patients were compared in terms of surgical parameters, pain, cervical spine function, range of motion, and complications. RESULTS The two groups of patients showed no significant differences in surgical time, blood loss, drainage volume, and length of hospital stay ( P > 0.05). No significant differences in the visual analogue scale (VAS), Japanese Orthopedic Association (JOA), and neck disability index (NDI) scores were observed between the two groups before surgery ( P > 0.05). The VAS and NDI scores in the observation group were considerably lower than those in the control group after surgery; however, the JOA scores in the observation group were significantly higher than those in the control group ( P < 0.05). No significant differences were observed in cervical disc height and the range of motion of the superior or inferior adjacent vertebrae between the two groups before surgery ( P > 0.05). The disc height in the observation group was larger than that in the control group after surgery. The range of motion of both the superior and inferior adjacent vertebrae was significantly smaller in the observation group than in the control group ( P < 0.05). The incidence of complications was only 2.22% in the observation group compared to 15.56% in the control group, and the difference was statistically significant ( P < 0.05). CONCLUSION Cervical spine function restoration was better with ROI-C with internal fixation in ACDF than with conventional titanium plates in ACDF for CDD disease.

Zero-profile anchored spacer versus conventional plate-cage construct in bilevel anterior cervical discectomy and fusion: a systematic review and meta-analysis

“…One potential rationale for this finding is as follows: while distinct fusion constructs are utilised, both surgical approaches directly decompress the spinal cord via removal of anterior pathological compression, for example, herniated discs, and hyperplastic bone at the posterior aspect of the vertebrae. A few trials found no significant differences between both interbody implants with regard to JOA score and NDI score at last follow-up for CDDD treatment [ 15 , 34 , 40 ]. Overall, our findings demonstrate both constructs have equally favourable effectiveness in both continuous and noncontinuous bilevel ACDF.…”