Cage with anterior plating is advantageous over the stand-alone cage for segmental lordosis in the treatment of two-level cervical degenerative spondylopathy: A retrospective study

Objectives To compare retrospectively the clinical and radiological outcomes in cervical spinal alignment after two consecutive levels PEEK cage-assisted ACDF when performed with or without plate fixation Patients and methods Seventy-eight patients underwent two consecutive levels PEEK cage-assisted ACDF without plating (56 patients) or supplemented with plating (22 patients). The average clinical follow-up was 31.40 ± 12.98 months. The authors compared clinical parameters (Neck disability index and Robinson criteria), perioperative parameters (hospital stays, complications), and radiological parameters (global lordotic curvature, segmental lordosis, segmental height). Results Demographic features, neurological presentation, preoperative sagittal alignment, postoperative complications, length of hospitalization and clinical improvement were not different between groups. At 12-months radiological follow-up, the global lordotic curvature was similar in both groups (P = 0.02). However, the use of anterior plate fixation versus stand-alone cage was associated with greater segmental lordosis (−7.68 ± 4.82° versus −0.02 ± 8.44° P < 0.0001) and greater segmental height (39.51 ± 3.50 versus 36.75 ± 3.90, P = 0.005). Conclusion The clinical outcomes after two consecutive levels PEEK cage-assisted ACDF with and without plate fixation were similar, but the supplement of an anterior plate was advantageous for improving segmental alignment on long-term radiological follow-up.