Stand-alone anchored cage versus cage with plating for single-level anterior cervical discectomy and fusion: a prospective, randomized, controlled study with a 2-year follow-up

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• 作者：Osamu Nemoto ; Akira Kitada ; Satoko Naitou…
• 关键词：Stand ; alone anchored cage ; Anterior cervical discectomy and fusion ; Prospective study
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：25
• 期：1-supp
• 页码：127-134
• 全文大小：569 KB
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• 作者单位：Osamu Nemoto (1)
  Akira Kitada (1)
  Satoko Naitou (1)
  Atsuko Tachibana (1)
  Yuya Ito (1)
  Akira Fujikawa (1)
  
  1. Department of Orthopaedic Surgery, Japanese Self Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Traumatic Surgery
  
• 出版者：Springer Paris
• ISSN：1432-1068

文摘

To avoid complications associated with plating in anterior cervical discectomy and fusion (ACDF), stand-alone anchored PEEK cage was developed and favourable outcomes with a low rate of dysphasia have been described. The objective of this study was to compare the clinical and radiological outcomes of ACDF using a standalone anchored PEEK cage (PREVAIL; Medtronic Sofamor Danek, Memphis, TN) with those of a PEEK cage with plating in a prospective randomized manner. Fifty patients with single-level cervical radiculopathy were randomly assigned to a PREVAIL or a PEEK cage with plating. Following 3, 6, 12, and 24 months, clinical and radiological outcomes were assessed. The mean surgical time for the patients with a PREVAIL was significantly shorter than that for those with a PEEK cage with plating. The clinical outcomes evaluated by visual analogue scale for pain and the Odom’s criteria were comparable between both the groups. Both the groups demonstrated the high fusion rate (92 % in PREVAIL; 96 % in PEEK cage with plating). The subsidence rate and the improvement of cervical alignment were comparable between both the groups. The incidence of adjacent-level ossification was significantly lower for patients with a PREVAIL than that for those with a PEEK cage with plating. The rate of dysphasia graded by the method of Bazaz and measurement of prevertebral soft tissue swelling indicated no significant differences between both the groups. Our prospective randomized study confirmed that stand-alone anchored PEEK cage is a valid alternative to plating in ACDF with a low rate of adjacent-level ossification. However, the potential to reduce the incidence of dysphasia was not confirmed.