Artikel
Standalone cages or conventional anterior plating for ACDF? A retrospective comparison study with 2 year follow-up on 377 patients
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Veröffentlicht: | 6. November 2018 |
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Objectives: Anterior cervical discectomy and fusion (ACDF) is a well-established technique used in the single- or multiple-level treatment of degenerative cervical spine disorders. Standalone cages have gained popularity secondary to their ease of implantation, reduced operating time, and lower profile compared to traditional graft and plate systems. The aim of this study was to assess differences in pain and clinical outcomes, including complication and readmission rates, following ACDF using either a standalone cage system or an interbody device with anterior plating.
Methods: Between 2014 and 2015 we identified 377 consecutive patients meeting study criteria. 211 patients underwent ACDF with a standalone system. 166 patients underwent ACDF with a plate and interbody construct. Patient-specific characteristics, surgical characteristics, and Numeric Pain Rating Scale (NRS) scores for neck pain were collected pre- and peri-operatively. Complication and readmission rates as well as NRS scores were collected at approximately two years postoperatively (mean of 714 ± 123 days). Analyses assessed group differences at baseline (patient and surgical characteristics), as well as group differences in NRS score changes and post-operative complication and readmission rates.
Results and conclusion: There were a number of significant differences in general demographics and surgical characteristics between the two groups. There was a significant difference in NRS change scores at 2 years follow-up favoring patients having undergone ACDF with a plate and interbody construct, controlling for sex and length of surgery (p=.02).
Both clinical and pain outcomes were better in the plate and interbody group, presumably resulting from biomechanical advantages when compared to standalone cage systems.