Comparison of stand-alone anchored spacer versus plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis: a preliminary investigation.

Comparison of stand-alone anchored spacer versus plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis: a preliminary investigation.

World Neurosurg. 2016 Feb 9;

Authors: Shi S, Zheng S, Li XF, Yang LL, Liu ZD, Yuan W

Abstract
OBJECTIVE: The application of stand-alone anchored spacer (SAAS) in anterior cervical discectomy and fusion (ACDF) has been proved to be safe and effective to treat cervical spondylosis. Skip-level ACDF with SAAS, fusing only the involved levels without anterior plates, may be the optimal treatment. The aim of the study is to compare the clinical outcomes, radiologic results of SAAS and plate-cage construct (PCC) in the treatment of 2 noncontiguous levels of cervical spondylosis.
METHODS: A total of 65 patients with 2 noncontiguous levels of cervical spondylosis were included in the retrospective review of prospective collected data. The clinical and radiologic outcomes were assessed using Japanese Orthopaedic Association score, Neck Disability Index, cervical alignment (CA), and range of motion (ROM) and disc height (DH) of intermediate segment (IS), respectively. All the aforementioned parameters were compared before and after surgery in the respective group, which were also compared between the two groups. Besides, the complications were also recorded. Correlations between the surgical outcome and various factors were also analyzed.
RESULTS: No significant differences existed in clinical results between the two groups (p>0.05). Additionally, no statistical significance were observed in fusion rate, CA, ROM and DH of IS, dysphagia and hoarseness (p>0.05). Preoperative JOA score and high-intensity signal in T2WI were important predictors for surgical outcome.
CONCLUSIONS: Skip-level ACDF with SAAS is a safe and effective treatment of 2 noncontiguous levels of cervical spondylosis without obvious contraindications, which can keep the IS intact, and have a low impact on the IS.

PMID: 26868426 [PubMed - as supplied by publisher]

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