A Comparative Study Between the Functional and Radiological Outcomes of ACDF Using Locking Stand Alone Cage And Anterior Cervical Plate With Titanium Disc Cage in Degenerative Cervical Spine Disease

Abstract

Background: Cervical spondylotic radiculopathy and myelopathy are common problems for which anterior cervical discectomy and fusion is a gold standard procedure. There are various implant options available, two of which are commonly used in practice. Anterior cervical cage with plate and locking standalone cage. Our study aims to compare these two methods to know the functional and radiological outcomes after Anterior cervical discectomy and fusion procedure. Materials and Methods: We performed a prospective comparative study of 60 patients with single or two level degenerative cervical spine disease with failed conservative management. They were divided randomly into 2 groups of 30 patients each one group treated using locking standalone cage and the other with anterior cervical plate with cage using Smith Robinson approach. The clinical outcome was measured using visual analogue scores, Robinson’s criteria and Neck disability index and the radiological outcome was assessed using cobb’s angle, segmental height and segment angle with a follow up period of 2 years. Results: At 2 years follow up, good functional outcomes were obtained in both implant groups in terms of Robinson criteria, neck disability index and visual analogue scale. And good radiological outcomes were obtained in both implant groups with 93.3% fusion rates in both groups. Significant dysphagia was seen in the cage with plate group(26.6%) and significant cage subsidence was noted in the standalone cage group(20%). Conclusion: The functional and radiological outcomes are superior at 2 years follow up in both implant groups. Hence standalone cage and cage with plate technique both are equally safe and effective treatment options in 1 or 2 level degenerative cervical spine disease. Keywords: Anterior cervical discectomy and fusion, Neck Disability Index, Visual Analogue scale, Locking standalone cage, Anterior cervical plate, cage subsidence, Robinson criteria