Multilevel anterior cervical fusion with standalone cage or cage-and-plate after cervical discectomy: Benefits and drawbacks

Eghbal, Keivan; Ahrari, Iman; Kamrani, Fazlollah; Mohamamdi, Somayeh; Saffarian, Arash; Jamali, Mohamad; Rakhsha, Abbas; Taheri, Reza; Rahmanian, Abdolkarim; Eqbal, Meisam

doi:10.1016/j.asjsur.2023.02.032

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Nowadays, ACDF has become extensively accepted as the standard procedure for treating symptomatic monosegmental CDDD with satisfactory clinical outcomes. However, as the number of compressed segments increases, the pathological presentation becomes more complex, and currently the surgical decision remains controversial [ 9 , 32 – 34 ]. Previously, numerous scholars undertook meta-analyses and compared the effectiveness and complications of ZAS and PCC in the treatment of single-level and multilevel CDDD, albeit with contradictory conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…One potential rationale for this finding is as follows: while distinct fusion constructs are utilised, both surgical approaches directly decompress the spinal cord via removal of anterior pathological compression, for example, herniated discs, and hyperplastic bone at the posterior aspect of the vertebrae. A few trials found no significant differences between both interbody implants with regard to JOA score and NDI score at last follow-up for CDDD treatment [ 15 , 34 , 40 ]. Overall, our findings demonstrate both constructs have equally favourable effectiveness in both continuous and noncontinuous bilevel ACDF.…”

Section: Discussionmentioning

confidence: 99%

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Zero-profile anchored spacer versus conventional plate-cage construct in bilevel anterior cervical discectomy and fusion: a systematic review and meta-analysis

Zhang,

Ju,

2023

J Orthop Surg Res

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Background Zero-profile anchored spacers (ZAS) and plate-cage constructs (PCC) are currently employed when performing anterior cervical discectomy and fusion (ACDF). Nevertheless, the efficacy and safety of both devices in bilevel ACDF remain controversial. The goal of our meta-analysis is to assess the overall long-term efficacy and security among ZAS and PCC in bilevel ACDF. Methods A search of four electronic databases was conducted to identify researches that compared ZAS with PCC for bilevel ACDF. Stata MP 17.0 software was used for this meta-analysis. Results Nine researches with a total of 580 patients were involved. In comparison to PCC, ZAS significantly reduced intraoperative bleeding and postoperative dysphagia rates. No significant differences were found concerning operation time, JOA score, NDI score, cervical Cobb angle, fusion rates, the incidence of adjacent segmental degeneration (ASD) and implant sinking rates at last follow-up. Conclusion Compared to PCC, ZAS achieved similar efficacy and security in bilevel ACDF with respect to operative time, JOA score, NDI score, cervical Cobb angle, fusion rates, implant sinking rates and ASD rates at final follow-up. It is worth noting that ZAS offered considerable benefits over conventional PCC for the reduction of intraoperative bleeding and postoperative dysphagia. Therefore, for patients requiring bilevel ACDF, ZAS seems superior to PCC. Given the limitations of our study, larger prospective randomised controlled trials are needed to establish reliable proof to consolidate our conclusions.

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Section: Discussionmentioning

confidence: 99%