Does a zero-profile anchored cage offer additional stabilization as anterior cervical plate?

Area of Science:

• Spine surgery
• Orthopedics
• Neurosurgery

Background:

• Anterior cervical interbody fusion is a common procedure for cervical degenerative diseases.
• Anchored cages (ACs) have emerged as an alternative to traditional cages with plates (CPs) and stand-alone cages (SCs).
• The comparative efficacy of ACs versus CPs and SCs regarding postoperative retention and motion stabilization remains unclear.

Purpose of the Study:

• To compare the postoperative retention and motion stabilization of three surgical methods for single-level anterior cervical interbody fusion: stand-alone cages (SCs), cages with plates (CPs), and anchored cages (ACs).
• To evaluate subsidence, fusion rates, and clinical outcomes for each method.

Main Methods:

• Retrospective cohort study comparing SCs (n=60), CPs (n=18), and ACs (n=23) for single-level anterior cervical interbody fusion.
• Evaluated cervical alignment, segmental angle, segmental height, and interspinous process distance in flexion/extension.
• Assessed subsidence, fusion rates, and clinical outcomes (visual analogue scale, Odom criteria) with a mean follow-up of 19.9 months.

Main Results:

• Cages with plates (CPs) and anchored cages (ACs) demonstrated significantly better postoperative retention than stand-alone cages (SCs) at 12 months.
• CPs provided significantly greater motion stabilization than SCs; no significant difference was found between ACs and SCs.
• Subsidence rates were 40.0% for SCs, 21.7% for ACs, and 11.1% for CPs. Fusion rates were 83.3% for SCs, 87.0% for ACs, and 100.0% for CPs.
• Clinical outcomes (pain scores, Odom criteria) were superior in the CP and AC groups compared to the SC group.

Conclusions:

• Anchored cages (ACs) offer comparable retention and clinical outcomes to cages with plates (CPs).
• However, ACs are inferior to CPs in terms of motion stabilization, subsidence prevention, and fusion rates.
• For patients requiring robust postoperative motion stabilization, cages with plates (CPs) are the preferred surgical option over ACs.