Comparison of Stand-Alone Anchored Spacer and Plate-Cage Construct for Surgical Treatment of Multilevel Cervical Degenerative Spondylopathy: A Meta-Analysis.

Abstract

Study DesignMeta-analysis study.ObjectivesWe aimed to compare clinical outcomes, radiologic parameters, and complications between the stand-alone anchored spacer and the plate-cage construct as treatment options for patients with multilevel cervical degenerative spondylopathy involving 3 or 4 levels.MethodsIn this meta-analysis, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search for relevant studies covered the Embase, PubMed, and Cochrane Central Register of Controlled Trials databases, encompassing data from the inception of each database up to July 1, 2024.ResultsThe analysis included 12 studies, involving a total of 817 patients. Patients in the stand-alone anchored spacer group exhibited decreased intraoperative blood loss and shorter surgical durations. Clinical outcomes, including visual analog scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, Neck Disability Index (NDI) scores, and Odom's criteria for clinical outcomes, demonstrated no significant differences between the two groups. Radiographic outcomes revealed no statistically significant difference in fusion rates between stand-alone cages and plate-cage constructs. However, the plate-cage group exhibited more favorable maintenance of segmental angle and cervical alignment (C2-C7 angle).ConclusionsBoth stand-alone anchored spacer and plate-cage constructs are viable treatment options for patients with cervical degenerative spondylopathy involving more than two levels. Stand-alone cages have the benefit of reducing intraoperative blood loss and shortening surgical durations, but they are associated with a higher risk of cage subsidence. Plate-cage constructs offer better maintenance of segmental angle and cervical alignment; however, they carry a higher risk of dysphagia.