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"Standalone Cage With Integrated Screw Fixation Versus Cage-Plate Fixation in Unilateral Cervical Facet
Anil Kumar1, Bhaskar Sarkar, Aman Verma
1Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, India.
Clinical Spine Surgery
|July 22, 2026
Summary
Stand-alone cages with integrated screw fixation offer a lower-morbidity option for unilateral cervical facet dislocations (UCFDs), providing comparable fusion and pain relief to traditional cage-plate fixation. This approach is suitable for carefully selected patients.
Area of Science:
- Spine surgery
- Orthopedic trauma
- Cervical spine injuries
Background:
- Unilateral cervical facet dislocations (UCFDs) are unstable spinal injuries requiring surgical stabilization.
- Anterior cervical discectomy and fusion with plate fixation is effective but associated with risks like dysphagia and longer operative times.
- Stand-alone cages with integrated screws present a less invasive alternative, but comparative data for UCFDs is limited.
Purpose of the Study:
- To compare the clinical and radiographic outcomes of stand-alone cages versus cage-plate fixation in patients with unilateral cervical facet dislocations.
- To evaluate fusion rates, pain relief, functional recovery, operative parameters, and complication rates between the two surgical techniques.
Main Methods:
- Retrospective cohort study of 30 patients with single-level UCFDs undergoing anterior cervical discectomy and fusion.
- Comparison between stand-alone cages with integrated screw fixation (n=12) and cage-plate constructs (n=18).
- Primary outcomes: 12-month fusion, Visual Analog Scale (VAS) for pain, and Neck Disability Index (NDI) for function. Secondary outcomes: operative time, blood loss, and complications.
Main Results:
- Both groups showed comparable fusion rates (83.3% vs. 94.4%) and improvements in VAS and NDI scores.
- Cage-plate fixation provided superior kyphosis correction (9.77° vs. 5.40°) but involved longer operative times and greater blood loss.
- Dysphagia occurred in 2 patients with cage-plate fixation; one patient with a stand-alone cage experienced subsidence.
Conclusions:
- Both stand-alone cages with integrated screw fixation and cage-plate constructs achieve comparable fusion and pain relief in UCFDs.
- Stand-alone cages represent a lower-morbidity alternative, particularly for carefully selected UCFD patients.
- Further prospective studies are needed to confirm these findings for this rare injury pattern.
