Comparison of the outcomes of cage-stand-alone with cage-with-plate fixation in one level and two levels for treating cervical disk diseases

Abstract

Introduction: Anterior cervical discectomy and fusion (ACDF) surgery is an accepted method for many spinal cord abnormalities. The purpose of this study was to evaluate the outcomes of treating patients with spinal cord lesions at one level or two levels through ACDF with cage-stand-alone (ACDF-CA) and ACDF with cage-with-plate fixation (ACDF-CP) surgery and comparing these results with each other. Methods: In this prospective, cross-sectional, descriptive study, eighty patients undergoing ACDF surgery were enrolled according to the inclusion and exclusion criteria. Demographic data, before and after surgery findings, and clinical symptoms were investigated. Data were collected by means of visual analog scale (VAS) and Neck Disability Index (NDI) questionnaires. The adverse effects and surgical outcomes were evaluated based on Odom's criteria and patients' satisfaction. The collected data of the groups were then compared and assessed. Results: There was no significant difference between the groups in regards of gender, age, duration of surgery to visit, surgical level, preoperative and postoperative VAS and cervical range of motion, preoperative NDI, results based on Odom's criteria, and satisfaction of patients (P > 0.05). The VAS, NDI, and range of motion scores were significantly reduced in the four groups after the operation compared to the preoperative stage. Postoperative NDI scores in the ACDF-CA group at one level were significantly lower than other groups (P < 0.05). Conclusion: Both of the methods revealed acceptable outcomes in comparison to the preoperative stage, and despite some minor differences, there are generally no significant differences in outcomes and complications.