Fixation of multiple level anterior cervical disc using cages versus cages and plating

Abstract

BackgroundCervical disc herniation is a common cause of neck, upper limb, and upper back pain. In severe cases, neurological deficit might occur. It is surgically treated anteriorly or posteriorly, anteriorly through both cervical discectomy and fusion (ACDF) using cages alone or using cages plus plating.ObjectivesWe aimed to evaluate the fusion rate and the clinical outcome of multiple level anterior cervical discectomy followed by cage fusion alone and cage fusion with plate insertion.Materials and methodsIn this prospective comparative study, 33 patients were included. Patients were divided into 2 groups: group A: 19 cases received ACDF and group B: 14 patients had ACDF plus plate fixation. Fusion rate was assessed by radiographs. Clinical outcome was assessed by the visual analog scale (VAS). Overall patients’ satisfaction postoperatively was graded according to Odom’s criteria.ResultsThe rate of fusion was 78.9% of patients in group A and 85.7% of patients in group B. Clinical outcomes were similar in both groups. Patient satisfaction according to Odom’s criteria of outcome grading showed 36.8% of patients had excellent recovery and 31.6% had good recovery in group A. While in group B, 42.9% of patients had excellent recovery and 21.4% had good recovery. The differences between both groups were not statistically significant (P = 0.19).ConclusionsACDF with or without plate fixation in more than two-level cervical discectomies achieves good stability and functional outcome. Addition of anterior cervical plate fixation resulted in a higher fusion rate and reduced cage subsidence than that of cage alone.