title: Comparison of a Stand-Alone Anchored Spacer Versus Plate-Cage Construct in the Treatment of Two Noncontiguous Levels of Cervical Spondylosis: A Preliminary Investigation.
abstract: The application of stand-alone anchored spacer (SAAS) in anterior cervical discectomy and fusion (ACDF) has been proven to be safe and effective to treat cervical spondylosis. Skip-level ACDF with SAAS, fusing only the involved levels without anterior plates, may be the optimal treatment. The aim of the study was to compare the clinical outcomes, radiologic results of SAAS, and plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis.
  
  
  
  A total of 65 patients with 2 noncontiguous levels of cervical spondylosis were included in the retrospective review of prospective collected data. The clinical and radiologic outcomes were assessed with the Japanese Orthopaedic Association score, Neck Disability Index, cervical alignment, and range of motion and disc height of intermediate segment, respectively. All the aforementioned parameters were compared before and after surgery in the respective group, which also were compared between the 2 groups. Complications also were recorded, and correlations between the surgical outcome and various factors were analyzed.
  
  
  
  No significant differences existed in clinical results between the 2 groups (P > 0.05). In addition, no statistical significance was observed in fusion rate, cervical alignment, and range of motion and disc height of intermediate segment, dysphagia, and hoarseness (P > 0.05). Preoperative Japanese Orthopaedic Association score and high-intensity signal in T2-weighted images were important predictors for surgical outcome.
  
  
  
  Skip-level ACDF with SAAS is a safe and effective treatment of 2 noncontiguous levels of cervical spondylosis without obvious contraindications, which can keep the IS intact, and have a low impact on the IS.
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors: Sheng
authors: S
authors: Shi
authors: Department of Endocrinology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors: Shuang
authors: S
authors: Zheng
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
authors: Xin-Feng
authors: XF
authors: Li
authors: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China.
authors: Li-Li
authors: LL
authors: Yang
authors: Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China. Electronic address: rjliuzd@163.com.
authors: Zu-De
authors: ZD
authors: Liu
authors: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China. Electronic address: spinewenyuan@126.com.
authors: Wen
authors: W
authors: Yuan
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D004185:Disability Evaluation; D017586:Diskectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Anterior cervical discectomy and fusion; Cervical spondylosis; Clinical feature; Intermediate segment; Stand-alone anchored spacer; Two noncontiguous levels