The Stand-Alone Cervical Cages with Integrated Screw Fixation: Results in 315 Consecutive Operated Levels

Abstract

Introduction Background: Cervical disc disease at C2/3, C3/4 and C7/T1 is less common. Fusion with cages & plating is the standard treatment at these levels and in multi-level disc disease. This is not without significant risks related to the need of larger exposure and anterior muscular dissection. Stand-alone cages with integrated screw fixation obviate the need for plating and larger exposure. Material and Methods To assess the exposure / cage related morbidities and fusion rates in Stand-Alone cervical cages with Integrated Screw Fixation. Design: Retrospective chart review. Subjects: 315 levels were operated in 253 patients from February 2009 to February 2015. Single and Multilevel cages were performed in 201 and 52 patients respectively. 201 of the 253 patients underwent single level discectomy with Stand-Alone cervical cages with Integrated Screw Fixation at C3/4 and C7/T1 levels. 52 patients underwent 114 multi-level discectomies with Stand-Alone cervical cages with Integrated Screw Fixation Results Operative time was shorter. There was no reported permanent exposure/ cage related morbidities in all operated levels. 3 patients with traumatic disc disruption required further surgery for lateral mass fixation. 12 patients had mild dysphagia that resolved during follow up with no patient having complains of dysphagia at 3- months follow up. Fusion rates were 95% at single level and 90% at multi-level discectomies at the last follow up. No patient required cage related surgical revision. Conclusion The current results support the use of Stand-Alone cervical cages with Integrated Screw Fixation especially at difficult levels at C3/4 and C7/T1 and in multi-level discectomies as it obviate the need for plating and larger exposure with less reported dysphagia and implant related complications.