title: Stand-alone cervical cages versus anterior cervical plate in 2-level cervical anterior interbody fusion patients: clinical outcomes and radiologic changes.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To compare the efficacy of 2-level anterior cervical discectomy and fusion with cage alone (ACDF-CA) and with cage and plate construct (ACDF-CPC) with regard to clinical outcome and radiologic changes.
  
  
  BACKGROUND
  The use of stand-alone cervical interbody cages in ACDF has become popular, but high subsidence rates have been reported in the literature.
  
  
  METHODS
  A total of 54 consecutive patients who underwent 2-level ACDF-CA or ACDF-CPC after suffering from cervical radiculopathy were divided into 2 groups: group A (n = 28) underwent ACDF-CA, group B (n = 26) underwent ACDF-CPC. Fusion rate, global and segmental kyphosis, disk height, and subsidence rate were assessed by radiolographs. Clinical outcomes were assessed using Robinson's criteria.
  
  
  RESULTS
  Solid fusion was achieved in 96.43% (27/28) in group A and in 96.15% (25/26) in group B. Fusion segmental kyphosis of >5 degrees occurred in 14.29% (4/28) of group A and in 7.69% (2/26) of group B; however, there was no statistical difference between the 2 groups (P>0.05). Subsidence occurred in 35.71% (10/28) of group A as compared with 11.54% (3/26) of group B (P<0.05). Clinical outcomes were similar in the 2 treatment groups.
  
  
  CONCLUSIONS
  The use of cage and plate construct in 2-level ACDF results in a shorter fusion duration and a lower subsidence rate than that of cage alone; however, there is no significant difference in the postoperative global and segmental alignment and clinical outcomes between groups.
authors.affiliation: *Department of Neurosurgery, Spine Center, Hallym University Sacred Heart Hospital †Department of Neurosurgery, College of Medicine, Yonsei University ‡Spine and Spinal Cord Research Institute, College of Medicine, Yonsei University §Department of Neurosurgery, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea.
authors.forename: Jae Keun
authors.initials: JK
authors.lastname: Oh
authors.forename: Tae Yup
authors.initials: TY
authors.lastname: Kim
authors.forename: Hyo Sang
authors.initials: HS
authors.lastname: Lee
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: You
authors.forename: Gwi Hyun
authors.initials: GH
authors.lastname: Choi
authors.forename: Seong
authors.initials: S
authors.lastname: Yi
authors.forename: Yoon
authors.initials: Y
authors.lastname: Ha
authors.forename: Keung Nyun
authors.initials: KN
authors.lastname: Kim
authors.forename: Do Heum
authors.initials: DH
authors.lastname: Yoon
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000601:surgery; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery; D008141:Lordosis / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome