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Document Type

Original Article

Abstract

Purpose: This study assessed clinical and radiological outcomes to support the surgical decision of ACDF using cages alone versus cage-with-plate fixation in patients with four-level spondylotic myelopathy of the cervical spine.

Methods: This study enrolled 30 patients with four levels of cervical spondylotic myelopathy. The C Group (n=15) was subjected to ACDF using four cages, and the C&P Group (n=15) had additional plate fixation. They were followed up clinically and radiologically for at least 12 months. Scheduled for surgical intervention in the neurosurgery department of Misr University and hospitals of Al Azhar University and Nasr Institute from October 2020 to September 2021.

Results: The operative time was significantly shorter in the Cage alone group. Neck and arm pain decreased after surgery in the two groups. The fusion percentage was 92%. The C2-C7 Cobb’s angle increased significantly following surgery in both groups with no significant intergroup difference. postoperative complications were more common in patients who underwent plate fixation procedures.

Conclusion: In this small-scale study involving 30 patients, we explored the outcomes of anterior cervical discectomy and fusion including patients' radiological and clinical data using cages alone versus plate fixation with cages after four-level ACD. Our analysis revealed that both techniques are similarly effective in improving patient outcomes. However, postoperative complications were more common in patients who underwent plate fixation procedures.

Keywords

anterior cervical discectomy and fusion; cervical spondylotic myelopathy; cervical plate; four-level cervical disc

Subject Area

Neurosurgery

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