Cage with anterior plating is advantageous over the stand-alone cage for segmental lordosis in the treatment of two-level cervical degenerative spondylopathy: A retrospective study

Clin Neurol Neurosurg. 2017 Dec:163:27-32. doi: 10.1016/j.clineuro.2017.10.014. Epub 2017 Oct 16.


Objectives: To compare retrospectively the clinical and radiological outcomes in cervical spinal alignment after two consecutive levels PEEK cage-assisted ACDF when performed with or without plate fixation PATIENTS AND METHODS: Seventy-eight patients underwent two consecutive levels PEEK cage-assisted ACDF without plating (56 patients) or supplemented with plating (22 patients). The average clinical follow-up was 31.40±12.98months. The authors compared clinical parameters (Neck disability index and Robinson criteria), perioperative parameters (hospital stays, complications), and radiological parameters (global lordotic curvature, segmental lordosis, segmental height).

Results: Demographic features, neurological presentation, preoperative sagittal alignment, postoperative complications, length of hospitalization and clinical improvement were not different between groups. At 12-months radiological follow-up, the global lordotic curvature was similar in both groups (P=0.02). However, the use of anterior plate fixation versus stand-alone cage was associated with greater segmental lordosis (-7.68±4.82° versus -0.02±8.44°, P<0.0001) and greater segmental height (39.51±3.50 versus 36.75±3.90, P=0.005).

Conclusion: The clinical outcomes after two consecutive levels PEEK cage-assisted ACDF with and without plate fixation were similar, but the supplement of an anterior plate was advantageous for improving segmental alignment on long-term radiological follow-up.

Keywords: Anterior cervical discectomy and fusion; Anterior cervical plate; Cervical spine alignment; Stand-alone cage; Subsidence.

MeSH terms

  • Adult
  • Aged
  • Bone Plates*
  • Cervical Vertebrae / surgery*
  • Diskectomy / methods
  • Female
  • Fracture Fixation, Internal / methods
  • Humans
  • Lordosis / diagnosis
  • Lordosis / surgery*
  • Male
  • Middle Aged
  • Neck / surgery*
  • Postoperative Complications / surgery*
  • Radiography / methods
  • Spinal Fusion / methods
  • Treatment Outcome