Treatment of multilevel cervical disc disease with standalone cervical cages with or without anterior plating: A prospective randomized comparative study.

Abstract

Purpose: The purpose of the study was to compare the results of anterior cervical discectomy and fusion (ACDF) using standalone cages versus cages with anterior plating for multilevel cervical disc disease with a 2-year follow-up.

Background: ACDF is a commonly performed procedure in cases of neural compression caused by osteophytes or disc material. Some spine surgeons have reported unsatisfactory outcomes and fusion rates secondary to a high rate of cage subsidence and pseudoarthrosis. Internal fixation using anterior cervical plate has been developed as an adjunct to ACDF to enhance the stability provided by the intervertebral cages.

Patients and methods: A total number of 60 consecutive patients diagnosed with multilevel cervical disc disease (two or more) underwent ACDF with or without additional anterior plating, between August 2021 and March 2022. Only 50 patients completed the follow-up which was ranged from 20 to 26 months.

Results: There were no significant differences between the two groups regarding age and sex. Comparing the pre and postoperative Visual Analog Scale (VAS) for both neck pain and brachialgia and neck disability index (NDI) in both groups was statistically significant. There was no significant statistical difference between the two groups regarding the postoperative clinical outcomes. There was a significant statistical difference in the fused segment lordotic angle (FSA) being greater in the plating group.

Conclusion: The use of stand-alone cages in two-level ACDF or more in our study had a shorter operative time and hospital stay when compared to ACDF with anterior plating with greater FSA in the plate group but with no difference in clinical outcome after 2-year follow-up.