Department of Spine Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
Eur Spine J. 2020 Nov;29(11):2734-2744. doi: 10.1007/s00586-020-06561-x. Epub 2020 Aug 8.
To evaluate the efficacy of locking stand-alone cage (LSC) compared with anterior plate construct (APC) in anterior cervical discectomy and fusion (ACDF).
A comprehensive literature search was carried out in PubMed, Embase, Web of Science, and Cochrane Library to screen randomized controlled trials (RCTs) that directly compared LSC with APC in ACDF. The Cochrane Collaboration's tool was used for assessment of study quality. Data were analyzed with the Review Manager 5.3 software.
A total of seven RCTs were included. The results revealed no significant differences between LSC and APC in ACDF regarding the fusion rate, Japanese Orthopaedic Association score, visual analogue scale score, neck disability index score, hospital stay, subsidence rate, cervical lordosis, segmental Cobb angle, and disc height. However, LSC was associated with a significantly shorter operation time, less blood loss, lower overall incidence of dysphagia, and lower adjacent-level ossification (ALO) rate compared with APC.
In summary, LSC is not only a safe and effective device for ACDF but also has the advantages of significantly reduced operation time, blood loss, overall incidence of dysphagia, and ALO rate over APC. Therefore, LSC is a better alternative than APC for the patients undergoing ACDF procedures.
评估在颈椎前路椎间盘切除融合术（ACDF）中，使用锁定型独立 cage（LSC）与前路钢板固定（APC）的疗效。
在 PubMed、Embase、Web of Science 和 Cochrane Library 中进行全面的文献检索，筛选出直接比较 LSC 与 APC 在 ACDF 中应用的随机对照试验（RCT）。使用 Cochrane 协作工具评估研究质量。使用 Review Manager 5.3 软件进行数据分析。
共纳入 7 项 RCT。结果显示，在 ACDF 中，LSC 与 APC 在融合率、日本矫形协会评分、视觉模拟评分、颈部残疾指数评分、住院时间、下沉率、颈椎前凸角、节段 Cobb 角和椎间盘高度方面无显著差异。然而，与 APC 相比，LSC 具有手术时间更短、出血量更少、吞咽困难总发生率更低以及邻近节段骨化（ALO）率更低的优势。
综上所述，LSC 不仅是 ACDF 的一种安全有效的装置，而且与 APC 相比，在手术时间、出血量、吞咽困难总发生率和 ALO 率方面具有显著优势。因此，对于接受 ACDF 手术的患者，LSC 是 APC 的更好选择。
