Abousayed Mahmoud, Elmiligui Yasser, Koptan Wael, Elhamaky Mostafa, Barakat Ahmed Samir, Sultan Ahmed Maher
Department of Trauma and Orthopaedics, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Craniovertebr Junction Spine. 2025 Jan-Mar;16(1):89-95. doi: 10.4103/jcvjs.jcvjs_148_24. Epub 2025 Apr 1.
The purpose of the study was to compare the results of anterior cervical discectomy and fusion (ACDF) using standalone cages versus cages with anterior plating for multilevel cervical disc disease with a 2-year follow-up.
ACDF is a commonly performed procedure in cases of neural compression caused by osteophytes or disc material. Some spine surgeons have reported unsatisfactory outcomes and fusion rates secondary to a high rate of cage subsidence and pseudoarthrosis. Internal fixation using anterior cervical plate has been developed as an adjunct to ACDF to enhance the stability provided by the intervertebral cages.
A total number of 60 consecutive patients diagnosed with multilevel cervical disc disease (two or more) underwent ACDF with or without additional anterior plating, between August 2021 and March 2022. Only 50 patients completed the follow-up which was ranged from 20 to 26 months.
There were no significant differences between the two groups regarding age and sex. Comparing the pre and postoperative Visual Analog Scale (VAS) for both neck pain and brachialgia and neck disability index (NDI) in both groups was statistically significant. There was no significant statistical difference between the two groups regarding the postoperative clinical outcomes. There was a significant statistical difference in the fused segment lordotic angle (FSA) being greater in the plating group.
The use of stand-alone cages in two-level ACDF or more in our study had a shorter operative time and hospital stay when compared to ACDF with anterior plating with greater FSA in the plate group but with no difference in clinical outcome after 2-year follow-up.
本研究的目的是比较使用独立椎间融合器与带前路钢板的椎间融合器进行颈椎前路椎间盘切除融合术（ACDF）治疗多节段颈椎间盘疾病并进行2年随访的结果。
ACDF是治疗由骨赘或椎间盘组织引起神经压迫病例的常用手术。一些脊柱外科医生报告称，由于椎间融合器下沉率和假关节形成率较高，导致治疗效果和融合率不尽人意。使用颈椎前路钢板进行内固定已被开发作为ACDF的辅助手段，以增强椎间融合器提供的稳定性。
2021年8月至2022年3月期间，共有60例连续诊断为多节段颈椎间盘疾病（两节或以上）的患者接受了有或没有额外前路钢板固定的ACDF手术。只有50例患者完成了随访，随访时间为20至26个月。
两组在年龄和性别方面无显著差异。比较两组术前和术后颈部疼痛和臂丛神经痛的视觉模拟量表（VAS）以及颈部功能障碍指数（NDI），差异具有统计学意义。两组术后临床结果无显著统计学差异。钢板固定组融合节段前凸角（FSA）更大，差异具有统计学意义。
在我们的研究中，与使用前路钢板的ACDF相比，在两节或更多节段的ACDF中使用独立椎间融合器手术时间更短，住院时间更短，钢板固定组的FSA更大，但2年随访后临床结果无差异。
