Stand-alone Cervical Cages Versus Anterior Cervical Plate in 2-Level Cervical Anterior Interbody Fusion Patients

Abstract

The use of cage and plate construct in 2-level ACDF results in a shorter fusion duration and a lower subsidence rate than that of cage alone; however, there is no significant difference in the postoperative global and segmental alignment and clinical outcomes between groups.

The influence of cervical plate fixation with either autologous bone or cage insertion on radiographic and patient-rated outcomes after two-level anterior cervical discectomy and fusion

“…In both groups a subsidence effect and loss of lordosis was measured, with a significantly greater effect in the group without APF. These results are consistent with those from other studies [17,11]. The greater preservation of segmental height and lordosis in the APF group might be due to stabilization of the operated segments within the first weeks after surgery while the autologous fusion was progressing.…”

“…Similar to previously published studies [19] our data showed that the use of a cage was superior to autologous bone in terms of restoration and preservation of disc height; also in accordance with the literature [11], we showed that APF was superior to a stand-alone technique. The effect of adding a plate was significantly more marked in the autologous bone group than in the cage group showing the importance of adding APF in this subgroup to guarantee preservation of disc height.…”

“…[17,11] A recently published prospective study, in which single level ACDF using either autologous bone fusion with APF or stand-alone cage fusion, reported improved radiological outcomes after APF but comparable clinical outcomes for both techniques. [8] However, Joo et al…”

“…[8,9] However, for more than 1-level ACDF there is currently no evidence in the literature suggesting superiority of one technique over any other, especially regarding the issue of whether APF is superior to the stand-alone technique. [10,11] Some smaller studies report an advantage of APF in terms of radiographic outcome, but there is no systematic study in the literature analyzing the influence of APF in terms of both patient-rated and radiographic outcomes in two-level ACDF. Therefore, we aimed to identify techniquerelated factors after two-level ACDF to evaluate whether the addition of an anterior cervical plate shows superiority over a stand-alone technique in terms of radiographic and patientrated outcome.…”

Short-Term Experience With a New Absorbable Composite Cage (β-Tricalcium Phosphate–Polylactic Acid) in Patients After Stand-Alone Anterior Cervical Discectomy and Fusion

“…Moreover, they show in combination with anterior plating excellent results in regard of the rate and quality of fusion. 12 Therefore, is seems questionable why for a comparable radiological result an absorbable cage should be used instead, which additionally has a much higher price compared with a standard PEEK cage.…”