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Updated: Sep 10, 2025
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
Reoperation Rate Following Single-Level Anterior Cervical Discectomy and Fusion With Standalone Cage Versus Anterior
Adeesya Gausper1, Andrew M Miller1, Vivien Chan1
1Department of Neurosurgery.
Study Design:
Retrospective study.
Objective:
To compare reoperation rates between single-level standalone anterior cervical discectomy and fusion (ACDF) and ACDF with anterior plating.
Summary Of Background Data:
ACDF is a widely performed procedure for cervical degenerative disc disease and may utilize standalone cages or cages with anterior plating. Reoperation rate serves as a critical measure of long-term success and durability of each technique.
Methods:
The PearlDiver national insurance claims database was used to identify patients who underwent single-level ACDF with a standalone cage or ACDF with a plate. 1:1 matched cohorts were created based on age, sex, Elixhauser Comorbidity Index score, and year of surgery. The primary outcome was the reoperation rate at 2 years postoperatively. Secondary analyses included reoperation rate at 1-year and 5-years, reoperation stratified by surgical approach, and rate of epidural or facet injections at 2-years after index surgery. Statistical analyses included χ2 tests and Kaplan-Meier analysis to compare reoperation rates.
Results:
Nine thousand three hundred twenty-six patients were included in each cohort after matching. The 2-year reoperation rate was 3.26% for ACDF with plate and 3.31% for standalone ACDF (P=0.837). No significant difference was found in reoperation rates at 1-year, 2-year, and 5-year. Kaplan-Meier analysis additionally demonstrated no significant difference in reoperation-free survival over time. Patients undergoing standalone ACDF had higher rates of posterior approach reoperations within 2 years (1.22% vs. 0.84%, P=0.011). No significant differences were found in the rate of epidural or facet injections between groups.
Conclusions:
Standalone and plated single-level ACDF provide comparable long-term outcomes in terms of reoperation rates. This study is the largest matched cohort to date of patients who underwent single-level ACDF with and without anterior plating.
Level Of Evidence:
Level III.
