A comparison of a self-locking stand-alone cage and anterior cervical plate for ACDF: Minimum 3-year assessment of radiographic and clinical outcomes

Zhou, Jian; Li, Juan; Lin, Hong; Li, Xilei; Zhao, Xiaogang; Dong, Jian

doi:10.1016/j.clineuro.2018.04.033

Cited by 50 publications

(101 citation statements)

References 26 publications

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“…After removing 26 duplicated studies and 22 non-English language articles, there were 173 studies left for screening and 163 of records were excluded according to the selection criteria. As a result, ten controlled trials [2,[9][10][11][12][13][24][25][26][27] were screened out for this meta-analysis. The literature search procedure was shown in Table 2 The quality assessment of included studies according to the MOOSE guidelines Nemoto [12] Shin [25] Lee [2] Shi [9] Chen [11] Li [13] Yun [26] Zhou [10] Lu [24] Zhu [27] surgical levels and other informations of patients in each study was listed in Table 1.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

“…Data regarding JOA and NDI scores postoperatively were documented in six studies consisting of 436 patients (ZP group: 217; CP group: 219) [9][10][11]13,24,27]. Mean difference of JOA scores at final followup between ZP and CP groups were not significant (WMD 0.07, 95% CI -0.12 to 0.25, P = 0.48).…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…The results of radiographic fusion were described in nine studies [2,[9][10][11][12][13]24,26,27], with fusion rate varying from 71 to 100%. Successful bone union was achieved in 348/377 cases (92.3%) in the ZP group, and 359/379 cases (94.7%) in the CP group.…”

Section: Radiological Assessmentmentioning

confidence: 99%

“…However, studies over the past decade have shown that the use of anterior plate can increase the incidence of postoperative dysphagia, and even cause long-term unremitting swallowing discomfort [5][6][7][8]. In order to solve this complication, many researchers have adopted a variety of new selflocking zero-profile anchored cage (ZP), such as Zero-P, MC + and ROI-C, etc [9][10][11][12][13]. These types of devices can reduce the compression of prevertebral soft tissue, and has similar stability and clinical efficacy as traditional cage-plate construct [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…These types of devices can reduce the compression of prevertebral soft tissue, and has similar stability and clinical efficacy as traditional cage-plate construct [14][15][16]. Meanwhile, the new devices are easy placement and can reduce the operation time and blood loss significantly [10,13], so the clinical application has gradually increased in recent years.…”

Section: Introductionmentioning

confidence: 99%

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Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis

Fang

Shen

et al. 2019

Preprint

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Background Zero-profile anchored cage (ZP) has been widely used for its lower occurrence of dysphagia. However, it is still controversial whether it has the same stability as the cage-plate construct (CP) and increases the incidence of postoperative subsidence. We compared the rate of subsidence after anterior cervical discectomy and fusion (ACDF) with ZP and CP to determine whether the zero-profile device had a higher subsidence rate?Methods We performed a meta-analysis of studies which compared the subsidence rate of ZP and CP. An extensive and systematical search covered Medline, Embase and Web of Science databases according to PRISMA guidelines and identified ten articles that satisfied our inclusion criteria. Relevant clinical and radiological data were extracted and analysed by RevMan 5.3 software.Results Ten trials involving 626 patients were included in this meta-analysis. The incidence of postoperative subsidence in ZP group was significantly higher than with CP group [15.1% (89/588) vs. 8.8% (51/581), OR = 1.97 (1.34, 2.89), P = 0.0005]. In subgroup analysis, we found that the definition of subsidence did not affect the higher subsidence rate in the ZP group. Considering the quantity of operative segments, there was no significant difference in the incidence of subsidence between the two groups after single-level fusion (OR 1.43, 95% CI 0.61-3.37, P = 0.41). However, the subsidence rate of the ZP group was significantly higher than the CP group (OR 2.61, 95% CI 1.55-4.40, P = 0.0003) after multi-level surgery. There were no significant differences in intraoperative blood loss, JOA score, NDI score, fusion rate and cervical aligment in the final followup between the two groups. In addition, the CP group had a longer operation time and a higher incidence of dysphagia at each follow-up time than the ZP group.Conclusion ZP had a higher risk of postoperative subsidence than CP. Although there was a high occurrence of swallowing discomfort, we are more agreed that the anterior plate should be used in multi-level surgery as far as possible to reduce the subsidence and adverse clinical symptoms in the long term.

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Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

Section: Clinical Evaluationmentioning

confidence: 99%

Section: Radiological Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis

Fang

Shen

et al. 2019

Preprint

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Cervical disc herniation: which surgery?

Mazas

Benzakour

Castelain

et al. 2018

International Orthopaedics (SICOT)

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Purpose Cervical disc herniation is a common pathology. It can be treated by different surgical procedures. We aimed to list and analyzed every available surgical option. We focused on the comparison between anterior cervical decompression and fusion and cervical disc arthroplasty. Results The anterior approach is the most commonly used to achieve decompression and fusion by the mean of autograft or cage that could also be combined with anterior plating. Anterior procedures without fusion have shown good outcomes but are limited by post-operative cervicalgia and kyphotic events. Posterior cervical foraminotomy achieved good outcomes but is not appropriate in a case of a central hernia or ossification of the posterior ligament. Cervical disc arthroplasty is described to decrease the rate of adjacent segment degeneration. It became very popular during the last decades with numerous studies with different implant device showing encouraging results but it has not proved its superiority to anterior cervical decompression and fusion. Anterior bone loss and heterotopic ossification are still to be investigated. Conclusion Anterior cervical decompression and fusion remain the gold standard for surgical treatment of cervical disc herniation.

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Factors influencing cage subsidence in anterior cervical corpectomy and discectomy: a systematic review

et al. 2023

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A comparison of a self-locking stand-alone cage and anterior cervical plate for ACDF: Minimum 3-year assessment of radiographic and clinical outcomes

Cited by 50 publications

References 26 publications

Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis

Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis

Cervical disc herniation: which surgery?

Factors influencing cage subsidence in anterior cervical corpectomy and discectomy: a systematic review

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