Degenerative Cervical Disorder—Stand-alone Cage Versus Cage and Cervical Plate: A Systematic Review

Abstract

Study Design: Systematic review. Objectives: The objective of this study was to compare clinical and radiological outcomes following discectomy and anterior cervical fusion for the treatment of cervical degenerative disorder performed with stand-alone cages and anterior cervical plates. Methods: Electronic searches were performed in the MEDLINE, LILACS, and Cochrane Systematic Reviews databases, according to PRISMA guidelines, with no language or date restriction. The review was registered in PROSPERO under number CRD42018109180. Results: Six randomized clinical trials were selected, which evaluated at least one of the objectives of this work, such as pain control, bone consolidation, neurological symptoms, and cervical lordosis, thus satisfying the inclusion criteria. Articles that did not directly compare the 2 surgical techniques were excluded. A total of 309 patients were included and the results showed no significant difference in clinical (visual analogue scale and neck disability index) or radiological (cervical lordosis and fusion) outcome between the 2 groups. The operative time was shorter in the group with stand-alone cages (mean difference = −18.40; 95% CI = [−24.89, −11.92]; P < .66). Conclusion: The stand-alone cages and anterior cervical plate techniques have similar clinical and radiological outcomes. Despite the significantly shorter operative time for one group, other randomized clinical trials are needed to establish conclusive evidence in favor of one of the comparative treatments.