Comparison of Clinical and Radiological Outcomes Between Self-Locking Stand-Alone Cage and Cage with Anterior Plate for Multilevel Anterior Cervical Discectomy and Fusion: A Meta-Analysis.

Comparison of Clinical and Radiological Outcomes Between Self-Locking Stand-Alone Cage and Cage with Anterior Plate for Multilevel Anterior Cervical Discectomy and Fusion: A Meta-Analysis.

World Neurosurg. 2019 Jan 21;:

Authors: Zhang D, Zhu D, Zhu J, Li C, Wei F, Yuan Y, Liu B

Abstract
OBJECTIVE: This meta-analysis was conducted to evaluate the therapeutic effects in clinical and radiological outcomes of between self-locking stand-alone cage (SSC) and cage-with-plate (CP) for multilevel anterior cervical discectomy and fusion (ACDF).
METHODS: A systematic search was performed for all comparative studies published up to August 2018. Operative time, hospital stay, intraoperative blood loss, Japanese Orthopedic Association (JOA) score, Neck Disability Index (NDI), cervical and segmental Cobb's angle, intervertebral height, fusion rate, incidence of subsidence, dysphagia and adjacent segment degeneration (ASD) were analyzed with the RevMan 5.3.3 software.
RESULTS: A total of 15 studies were included. There was no difference with regard to preoperative or postoperative JOA score, NDI, segmental Cobb's angle and intervertebral height, preoperative cervical Cobb's angle, fusion rate, incidence of subsidence and ASD between SSC and CP group (p>0.05). While, the SSC group had shorter operative time (MD: -11.35, 95% CI: [-16.24, -3.66]) and hospital stay (MD: -0.64, 95% CI: [-1.21, -0.06]), less intraoperative blood loss (MD: -13.22, 95% CI: [-19.03, -7.41]) and postoperative cervical Cobb's angle (MD: -0.70, 95% CI: [-1.35, -0.06]) and lower incidence of dysphagia significantly (OR: -0.57, 95% CI: [0.40, 0.82]) (p<0.05).
CONCLUSION: ACDF with SSC and CP in multilevel cervical spondylosis achieved similar clinical relief. Although CP maintained better cervical lordosis, the SSC contributed to less surgical pain and complications. ACDF with SSC is safe and efficient in treating multilevel cervical spondylosis.

PMID: 30677575 [PubMed - as supplied by publisher]

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