• Eur Spine J · Dec 2024

    Review

    Long-term effectiveness of stand-alone anchored spacer in multilevel anterior cervical discectomy and fusion compared with cage-plate system: a systematic review and meta-analysis.

    • Yu Zhang, Jidong Ju, and Jinchun Wu.
    • Department of Orthopaedics, Jingjiang People's Hospital Affiliated to Yangzhou University, Jingjiang, Taizhou, Jiangsu Province, 214500, China.
    • Eur Spine J. 2024 Dec 19.

    ObjectiveFor anterior cervical discectomy and fusion (ACDF), stand-alone anchored spacers (SAAS) and cage-plate system (CPS) are currently employed. However, controversy remains over the effectiveness and security of these two apparatuses in multilevel ACDF. The aim of this study was to demonstrate the global long-term effectiveness and safety of SAAS versus CPS with multilevel ACDF.MethodsWe conducted a systematic review of studies comparing SAAS with CPS for multilevel ACDF using four electronic databases. Data from this meta-analysis were analyzed with Stata MP 17.0.ResultsA total of nine trials comprising 584 patients were selected for inclusion. SAAS significantly reduced operative time, intraoperative bleeding and the incidence of postoperative dysphagia compared with CPS. The SAAS group exhibited significantly smaller cervical sagittal angle (CSA) and fusion segmental height (FSH) compared to CPS group. At final follow-up, the rate of cage sinking was higher in SAAS group compared to CPS group. At the endpoint, there was no difference in JOA score, NDI score, fusion rate or the incidence of adjacent segment degeneration (ASD).ConclusionsSAAS provided comparable long-term effectiveness and safeness for multilevel ACDF regarding JOA scores, NDI scores, fusion rates and ASD rates at endpoint compared to CPS. In comparison to CPS, SAAS demonstrated significant advancement in the reduction of operative time, intraoperative blood loss and the incidence of postoperative dysphagia. As a consequence, SAAS appeared more desirable than CPS among people who needed multilevel ACDF. Yet in long-term observation, SAAS was inferior to CPS in maintaining CSA and FSH and in preventing cage descent. However, whether or not radiographic abnormality has an impact on clinical presentation awaits confirmation from research with more longitudinal follow-up.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…